The impact of levodopa therapy-induced complications on quality of life in Parkinson’s disease patients in Singapore

• Published in: Scientific reports Vol. 9; no. 1; pp. 9248 - 6
• Main Authors: Wu, Jonathan, Lim, Ee-Chien, Nadkarni, Nivedita V., Tan, Eng-King, Kumar, Prakash M.
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 25.06.2019; Nature Publishing Group
• Subjects: 692/617/375/1718; 692/700/784; Activities of Daily Living; Aged; Antiparkinson Agents - adverse effects; Cognition; Dyskinesia; Dyskinesia, Drug-Induced - epidemiology; Dyskinesia, Drug-Induced - etiology; Dyskinesia, Drug-Induced - pathology; Female; Humanities and Social Sciences; Humans; Incidence; Levodopa; Levodopa - adverse effects; Longitudinal Studies; Male; Middle Aged; Movement disorders; multidisciplinary; Neurodegenerative diseases; Parkinson Disease - drug therapy; Parkinson Disease - pathology; Parkinson's disease; Population studies; Quality of Life; Science; Science (multidisciplinary); Severity of Illness Index; Singapore - epidemiology; Treatment Outcome; Singapore
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-019-45110-5

The objective of this study was to investigate the impact of levodopa therapy-induced complications on the quality of life (QoL) of Parkinson’s disease (PD) patients in Singapore over a 1-year follow-up period. 274 PD patients were prospectively recruited, of which 78 patients completed the follow-up. Patients were evaluated on: (1) motor symptoms, (2) non-motor symptoms, (3) levodopa therapy-induced complications and (4) QoL. Levodopa-induced complications including dyskinesia and OFF symptoms occurred in 13.5% and 55.9% of the study population, respectively. In patients who completed the 1-year follow-up, there was a trend suggestive of increasing dyskinesia duration, more disabling dyskinesia as well as longer, more sudden and unpredictable OFF periods. There was a significant decline in the overall QoL at follow-up, in particular, activities of daily living, emotional well-being, cognition and communication domains were the most affected. The multivariable analysis demonstrated that worsening of UPDRS IV total score over 1-year interval was associated with worsening in PDQ-Summary Index score (d = 0.671, p = 0.014). In conclusion, levodopa-induced complications had significant adverse impacts on QoL. This study substantiates the importance for clinicians to closely monitor and promptly manage levodopa therapy-induced complications that may arise in patients.