Prevalence of fatigue in Parkinson disease and its clinical correlates

Fabrizio Stocchi; Giovanni Abbruzzese; Roberto Ceravolo; Pietro Cortelli; Marco D'Amelio; Maria F De Pandis; Giovanni Fabbrini; Claudio Pacchetti; Gianni Pezzoli; Alessandro Tessitore; Margherita Canesi; Claudio Iannacone; Mario Zappia; FORTE Study Group

doi:10.1212/WNL.0000000000000587

Prevalence of fatigue in Parkinson disease and its clinical correlates

Neurology. 2014 Jul 15;83(3):215-20. doi: 10.1212/WNL.0000000000000587. Epub 2014 Jun 13.

Affiliations

¹ From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy. fabrizio.stocchi@sanraffaele.it.
² From the Institute of Neurology (F.S.), IRCCS San Raffaele Pisana, Rome; Section of Neurology (G.A.), DINOGMI, University of Genoa; Department of Neuroscience (R.C.), University of Pisa; IRCCS Institute of Neurological Sciences of Boulogne (P.C.), Department of Biomedical and Neuromotor Sciences (DIBINEM), Alma Mater Studiorum, University of Boulogne; Department of Experimental Biomedicine and Clinical Neurosciences (M.D.), University of Palermo; Parkinson Operative Unit (M.F.D.P.), San Raffaele Institute, Cassino (FR); Department of Neurology and Psychiatry (G.F.), and IRCSS Neuromed, La Sapienza University of Rome; Parkinson's Disease and Movement Disorders Unit (C.P.), IRCCS Neurological National Institute C. Mondino, Pavia; Parkinson Institute (G.P., M.C.), I.C.P., Milan; Department of Neurology (A.T.), Second University of Naples; LB Research (C.I.), Cantù (CO); and Department G.F. Ingrassia (M.Z.), Neurosciences Area, University of Catania, Italy.

PMID: 24928125
DOI: 10.1212/WNL.0000000000000587

Abstract

Objective: To assess in a noninterventional setting the prevalence and severity of fatigue in patients with Parkinson disease (PD).

Methods: This was a cross-sectional study conducted in Italian patients with PD. Objectives included the evaluation of the current prevalence and severity of fatigue in patients with PD measured using the 16-item Parkinson Fatigue Scale (PFS-16), distressing fatigue (defined as a PFS-16 mean score ≥3.3), and assessment of its clinical correlates.

Results: A total of 402 patients were enrolled and 394 patients completed the PFS-16 questionnaire with a PFS-16 mean (±SD) score of 2.87 ± 0.99. Of these, 136 patients (33.8%) reported distressing fatigue (PFS-16 mean score ≥3.3). Patients with distressing fatigue were older (p = 0.044) and had a longer duration of PD (p < 0.0001) than those without distressing fatigue. The presence of distressing fatigue was associated with higher total Unified Parkinson's Disease Rating Scale (UPDRS) scores, poorer quality of life (39-item Parkinson's Disease Questionnaire [PDQ-39]), worse social and psychological behaviors, a higher severity of depressive symptoms, and a higher prevalence of sleep disorders (all p < 0.001). Logistic regression analyses revealed that higher total UPDRS scores, female sex, depression, sleep disorders, as well as higher UPDRS activities of daily living scores and PDQ-39 mobility scores increase the likelihood of distressing fatigue in patients with PD.

Conclusions: Approximately one-third of patients with PD have distressing fatigue, which is significantly associated with depression and sleep disorders. The fact that the presence of fatigue worsens patient quality of life supports the need to better diagnose and treat this debilitating symptom.

Publication types

Comparative Study
Multicenter Study
Observational Study
Research Support, Non-U.S. Gov't

MeSH terms

Adult
Age Factors
Aged
Aged, 80 and over
Cross-Sectional Studies
Depression / epidemiology*
Depression / physiopathology
Fatigue / epidemiology*
Fatigue / physiopathology
Female
Humans
Italy / epidemiology
Male
Middle Aged
Parkinson Disease / classification
Parkinson Disease / epidemiology*
Parkinson Disease / physiopathology
Prevalence
Severity of Illness Index
Sleep Wake Disorders / epidemiology*
Sleep Wake Disorders / physiopathology
Time Factors