THE HEALTH BURDENS OF PARKINSONS-DISEASE

Parkinson's disease (PD) is likely to have a substantial impact on an individual's health-related quality of life (HRQL), health-related res ource use, and productivity. Data about the health burdens of PD by di sease stage are fundamental to understanding the effectiveness of care , both from a clinical and a fiscal point of view. This study's goal w as to describe the associations of patient-reported HRQL and economic characteristics with PD stage. We hypothesized that later stages of PD would be associated with poorer HRQL, greater health-related resource use. and lower work productivity than early stages of PD. We used a c ross-sectional analysis to Study 193 PD patients attending two hospita l-based neurology clinics. Self-administered questionnaires and in-per son interviews measured clinical features, functional status, general health perceptions, well-being, overall HRQL, work productivity, and h ealth-related resource use. Consistent, strong associations were found between stage and functional status, general health perceptions, well -being, and overall HRQL even after controlling for age, gender, and c omorbid conditions. Most resource use and work productivity measures w ere also associated with disease stage. However, physician services us e was not. This study confirms that the burdens of illness are progres sively higher for PD patients with early, moderate, and advanced illne ss. The results suggest that such important facets of the health burde n as HRQL and health-related resource use may be seriously misjudged i f not carefully measured bur inferred from clinical observations alone .