Stigma and Associated Correlates of Elderly Patients With Parkinson's Disease

Background: Stigmatizing experiences is common in Parkinson's disease (PD) and appears to provide a negative contribution to the quality of life. Our aim of this study was to investigate the extent of stigma and its predictive factors in patients with PD from our hospital in Shanghai, China.Methods: In 276 individuals with PD (135 women and 141 men), stigma was measured by the 24-item Stigma Scale for Chronic Illness (SSCI). Multivariate linear regression model was used to assess predictors of stigma including demographics (age and gender), disease duration, stage (Hoehn and Yahr Scale), motor function (Unified Parkinson's Disease Rating Scale Part 3, UPDRS-III), non-motor symptoms (Non-Motor Symptoms Scale, NMSS), cognitive level (Mini-Mental State Examination, MMSE), as well as anxiety (Hamilton Anxiety Rating Scale, HAM-A) and depressive disorders (Hamilton Depression Rating Scale, HAM-D-24).Results: The total score of SSCI was 49.9 ± 14.3, and 48.5% of the patients checked “rarely” to “sometimes.” For the total sample, the full model accounted for 47.8% of the variance in stigma (P < 0.05). Higher UPDRS-III scores, longer course of disease, younger age, tremor-dominant subtype, and higher depression scores were significantly associated with stigma among individuals with PD.Conclusion: Our finding suggested a mild-to-moderate level of stigma in patients with PD. Tremor-dominant subtype, longer course of disease, younger age, severe motor symptoms, and depression are the predictors of stigma in PD.

Baseline motor findings and Parkinson disease prognostic subtypes

Objective:To identify the significance of baseline motor features to the lifelong prognostic motor subtypes in a Parkinson disease (PD) cohort.Methods:In a previous study of 166 PD cases, we observed different prognosis in tremor-dominant, akinetic-rigid, and mixed subtypes. This study includes the same cases, but we excluded 10 cases with symptoms of ≥15 years duration at baseline. Relative severity of tremor, bradykinesia/akinesia, and rigidity at baseline were evaluated as predictors of the motor subtypes, which are known to have different prognosis.Results:The most common motor subtype was mixed, followed by akinetic-rigid and then the tremor-dominant. Seventy cases were not receiving antiparkinsonian drugs at baseline. The prognostic subtypes could be predicted at baseline in 85% of all and in 91% of the treatment-naive cases. Sensitivity, specificity, and positive predictive values were strong for the mixed and the akinetic-rigid but weak for the tremor-dominant subtype.Conclusions:Our data show that motor profile at baseline can predict prognosis in most PD cases. These findings can be incorporated into clinical practice.