Gender Differences and Impact of Autonomic Disturbance on Fatigue and Quality of Life in Parkinson's Disease

• Published in: Neurology India Vol. 70; no. 1; pp. 203 - 208
• Main Authors: Bansal, Nahush, Paul, Birinder, Paul, Gunchan, Singh, Gagandeep
• Format: Journal Article
• Language: English
• Published: India Wolters Kluwer India Pvt. Ltd 01-01-2022; Medknow Publications and Media Pvt. Ltd; Medknow Publications & Media Pvt. Ltd
• Subjects: Activities of Daily Living; Autonomic neuropathies; Complications and side effects; Demographic aspects; Fatigue; Fatigue - etiology; Female; Gender differences; Health aspects; Humans; Male; Parkinson Disease - diagnosis; Parkinson's disease; Quality of Life; Risk factors; Severity of Illness Index; Sex Factors; India; quality of life Key Message:There was a significant variation of autonomic symptoms with gender in PD. Disease severity and duration were risk factors for autonomic dysfunction. Autonomic dysfunction may even be associated with fatigue and has a negative impact on the quality of life; fatigue; Parkinson's disease; gender differences; Autonomic symptoms; quality of life
• ISSN: 0028-3886; 1998-4022
• DOI: 10.4103/0028-3886.336334

Background: Autonomic dysfunction can precede the onset of motor symptoms in Parkinson's disease and are very disabling, but often overlooked.
Objective: This study was done to assess the presence of autonomic symptoms in PD; evaluate any gender differences and association of autonomic dysfunction with fatigue and quality of life.
Methods: Demographic profile and disease characteristics of PD patients were assessed. Autonomic symptoms were evaluated by SCOPA-AUT, fatigue by FSS, and QOL with PDQ-39 in patient's vernacular language. Patients with SCOPA-AUT score ≥9 were considered as having autonomic impairment. Gender variation in the involvement of different domains were analyzed along with the risk factors for autonomic dysfunction.
Results: Among 94 patients, 59 (63%) had autonomic dysfunction. All SCOPA domains showed significant impairment in PD. Nocturia (69.14%) and constipation (52.12%) constituted most frequent symptoms in our cohort. Mean urinary (7.89 vs. 6.05) and sexual (1.47 vs. 0.42) domain scores were significantly (P < 0.05) higher in males while cardiovascular dysfunction (0.81 vs. 1.64) was predominant in females. Patients with autonomic dysfunction had longer duration of disease (P = 0.033), severe disease (P = 0.0001) with higher UPDRS (P = 0.001). Autonomic symptoms correlated significantly (P < 0.0001) with Fatigue (r = 0.60) also. Patients with autonomic dysfunction had poor QOL (r = 0.67) and mobility, activities of daily living, emotional well-being, stigma, cognition, communication, and bodily-discomfort dimensions were worst affected (P < 0.05).
Conclusions: There was a significant variation of autonomic symptoms with gender. Disease severity and duration were significant risk factors for autonomic dysfunction. Also there was a strong co-relation of fatigue and poor QOL with autonomic dysfunction.