Factors associated with progression of non‐motor symptoms and deterioration in quality of life in Parkinson's disease: Results of J‐FIRST, a 1‐year observational study

Background Worsening motor symptoms are associated with deteriorations in health‐related quality of life (HrQOL) in patients with Parkinson's disease (PD). Aim Because few studies have examined whether non‐motor symptoms (NMSs) predict worsening of overall NMSs and HrQOL, we investigated whether NMSs are associated with the changes in these outcomes in patients with PD. Methods We used data from J‐FIRST, a 52‐week study of patients with PD, ≥1 NMS, and wearing‐off under levodopa treatment. Changes in Movement Disorders Society–Unified Parkinson's Disease Rating Scale (MDS‐UPDRS) Part I and 8‐item Parkinson's Disease Questionnaire (PDQ‐8) total scores during the observation period were compared between patients with and without individual NMSs at baseline. Relationships among NMSs were analyzed by cluster analysis. Results The analyses comprised 996 patients. The MDS‐UPDRS Part I total scores significantly increased in patients with cognitive impairment, depressed mood, and apathy, but significantly decreased in patients with features of dopamine dysregulation syndrome, relative to the changes in patients without these NMSs at baseline. The PDQ‐8 total scores significantly increased in patients with cognitive impairment, hallucinations and psychosis, depressed mood, apathy, pain and other sensations, urinary problems, and fatigue relative to the changes in patients without these NMSs at baseline. NMSs were broadly clustered into cognitive/mental functions, and autonomic functions and sleep. Light headedness on standing, fatigue, and pain and other sensations were closely related. Conclusion We observed significant deteriorations in the NMS burden and HrQOL in patients with cognitive, mental, or autonomic‐related NMSs.