Identifying factors affecting Quality of Life In Parkinsons Disease

INTRODUCTION

BACKGROUND OF THE STUDY :

Parkinson’s disease (PD) is a chronic and progressive degenerative neurological disorder characterized by the degeneration of dopamine neurons in the substantia nigra and formation of intracellular Lewy inclusion bodies (Jellinger, 1987). The resulting dopamine deficiency within the basal ganglia leads to a movement disorder characterized by classical parkinsonian motor symptoms. In early PD the full triad of clinical symptoms and signs (rest tremor, bradykinesia, and rigidity) may not yet be manifested.

 Parkinson’s disease was first medically described as a neurological syndrome by James Parkinson in 1817, although some aspects of Parkinson’s disease were reported in earlier descriptions. For example, Sylvius de la Boë wrote of resting tremor and Sauvages described festination. Much earlier, traditional Indian texts from approximately 1000 BC and ancient Chinese sources also provided descriptions that were reminiscent of Parkinson’s disease. Over 50 years later, Jean-Martin Charcot was more thorough in his descriptions and distinguished bradykinesia as a separate cardinal feature of the illness.

 Quality of life (QOL) is a broad and multi-dimensional concept that includes physical and mental health, social functioning, and emotional well-being (World Health Organization, 1993). Due to the need to improve quality of life for the elderly, several studies have been conducted to examine factors affecting QOL among older adults. Extant research has yielded several key factors including, demographic factors (e.g., advanced age, marital status, employment, higher education, etc; family relationship and social support, religious affiliation, and depression. More importantly, physical activity (PA), including sport participation, has consistently been positively associated with QOL in older adults.

 Parkinson’s disease (PD) is a chronic progressive disorder for which there is no cure. The major motor symptoms of PD are resting tremor, bradykinesia, rigidity, and postural reflex disturbance. Apart from these dopaminergic motor symptoms, non-motor symptoms also develop secondary to serotonergic, noradrenergic, cholinergic, and autonomic nervous system involvement, including major neuropsychiatric symptoms, autonomous disorders, sleep disorders, and sensory symptoms. Non-motor symptoms are seen in about 90% of PD patients in all stages of the disease. However, these symptoms are usually not recognized and are underestimated when planning therapeutic strategies.

 It affects many aspects of patients’ lives, only some of which can be appreciated by available clinical rating scales. Subjective evaluation of quality of life (QOL) and health status is therefore increasingly recognized to be important in the assessment and treatment of PD patients. Evaluation of QOL has been made possible recently by the development of valid, reliable, and sensitive instruments.

  NEED OF STUDY

§  Prevalence of Parkinson’s Disease in North India is 67.71 per 1 lakh individuals.

§  Studies have been found that Parkinson’s disease affect mainly balance and gait causing problems in their ADL’s. The progressive nature of disease affect Quality Of Study embarking it as a main indicator for assessing health related outcome.

§  Study stated that there is clear demarcation present in world wide population and Indian population of Parkinson’s disease. Depending upon the ethnicity, Geographical Variation, Indian Parkinson’s disease has variations from other western countries.

§  There are very few studies available on assessing Quality of life in Parkinson’s disease for Indian Scenario.

§  There are cultural differences in western countries and in India like eating habits, way of praying, Ambulation, socio economic status, etc. there is need to assess the problem list of Parkinson’s disease in Maharashtra, Indian scenario.

§  Hence, to identify the same self made questionnaire would help.