Fatigue in Parkinson's disease: A systematic review and meta‐analysis

冷漠 萧条(经济学) 医学 荟萃分析 帕金森病 生活质量(医疗保健) 焦虑 疾病 内科学 心理干预 物理疗法 精神科 宏观经济学 护理部 经济
作者
Mattia Siciliano,Luigi Trojano,Gabriella Santangelo,Rosa De Micco,Gioacchino Tedeschi,Alessandro Tessitore
出处
期刊:Movement Disorders [Wiley]
卷期号:33 (11): 1712-1723 被引量:186
标识
DOI:10.1002/mds.27461
摘要

ABSTRACT We conducted a systematic review and meta‐analysis aimed at establishing robust prevalence estimates and identifying clinical correlates of fatigue in PD. From 2,459 titles and abstracts, we selected 44 relevant studies (n = 7427 patients). Overall, the meta‐analysis showed a prevalence of fatigue of 50% in PD. This prevalence estimate, however, was significantly moderated by study heterogeneity in measurement scales and cut‐off thresholds. In contrast, demographic features, disease severity, cognitive impairment, and depression did not moderate prevalence estimates. Moreover, fatigue prevalence did not differ between de novo and treated PD patients. Compared to nonfatigued patients, fatigued patients had sligthly higher age (1.44 years), disease duration (0.93 years), l ‐dopa equivalent daily dose (50.89 units), UPDRS‐III (4.99 points), and H & Y (0.33 points), as well as risk of comorbid depression (risk ratio = 1.89) and had a little lower MMSE score (–0.66 points). Fatigue was moderately associated with apathy (Hedges' g = 0.55), anxiety (Hedges' g = 0.67), daytime somnolence (Hedges' g = 0.43), sleep disturbances (Hedges' g = 0.66), and poorer quality of life (Hedges' g = 1.23). Our analyses suggest that fatigue is a frequent, independent nonmotor symptom in PD appearing early and persisting throughout the disease course, and that establishing uniform diagnostic criteria for PD‐related fatigue is critical. In addition, several nonmotor symptoms appear to be associated with fatigue and negatively impact quality of life. Pharmacological and nonpharmacological interventions targeting fatigue and associated symptoms may improve quality of life in patients with PD. © 2018 International Parkinson and Movement Disorder Society
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