3175 Symptom burden and impact on quality of life for those with advanced Parkinson's in a rural area

Abstract

Introduction We recruited older adults with advanced Idiopathic Parkinson’s disease (IPD) to better understand their symptom burden and its impact on quality of life (QoL) in the predominately rural area of North Cumbria. Methods Records were taken from an IPD prevalence study. Those identified with advanced IPD, defined by Hoehn and Yahr stage 4 or 5, were invited to participate, consultee was contacted for those unable to consent. Quantitative data were collected using validated questionnaires. These included the Movement Disorder Society Non-Motor Symptoms (NMS) Questionnaire and the Parkinson’s Disease Questionnaire. Data were collected electronically with the participant, with assistance from a relative or carer if asked, or consultee as appropriate. Rural areas were defined as living in a settlement of less than 10,000 people. Results All 62 recruited participants experienced NMS, the number ranging between six and 17. Most frequently reported symptoms were sleep disturbance and physical fatigue. Physical fatigue was the most severely reported symptom. Mean NMS score for those living in a rural area (207.8 ± 87.9) was higher than that for those living in an urban area (180.0 ± 62.1), although this did not reach statistical significance (p = 0.17). In rural areas, mental fatigue was the most frequently reported symptom, while those living in urban areas reported sleep disturbance most frequently. Mean NMS score was higher in males (198 ± 85.5) than females (189 ± 67.4), although this did not reach statistical significance (p = 0.67). Mean PDQ-39 scores, an indicator of QoL, were similar in rural (40.6 ± 10.9) and urban (39.4 ± 10.4) areas and similar in males (39.6 ± 10.1) and females (40.5 ± 11.2). Conclusion Sleep disturbance and physical fatigue were frequently and severely reported NMS. Despite a higher NMS burden described in rural areas, QoL was similar between rural and urban areas. This could suggest possible protective factors improving QoL in rural areas.