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The major impact of freezing of gait on quality of life in Parkinson’s disease

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Abstract

Freezing of gait (FOG) is a disabling motor symptom experienced by a large proportion of patients with Parkinson’s disease (PD). While it is known that FOG contributes to lower health-related quality of life (HRQoL), previous studies have not accounted for other important factors when measuring the specific impact of this symptom. The aim of this study was to examine FOG and HRQoL while controlling for other factors that are known to impact patient well-being, including cognition, motor severity, sleep disturbance and mood. Two hundred and three patients with idiopathic PD (86 with FOG) were included in the study. All patients were between Hoehn and Yahr stages I–III. A forced entry multiple regression model evaluating the relative contribution of all symptoms was conducted, controlling for time since diagnosis and current dopaminergic treatment. Entering all significantly correlated variables into the regression model accounted for the majority of variance exploring HRQoL. Self-reported sleep–wake disturbances, depressive and anxious symptoms and FOG were individually significant predictors. FOG accounted for the highest amount of unique variance. While sleep–wake disturbance and mood have a significant negative impact on HRQoL in PD, the emergence of FOG represents the most substantial predictor among patients in the earlier clinical stages of disease. This finding presumably reflects the disabling loss of independence and fear of injury associated with FOG and underlines the importance of efforts to reduce this common symptom.

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Acknowledgments

We would like to thank the patients of the Parkinson’s Disease Research Clinic for being so generous with their time and efforts. CC Walton is supported by an Australian Postgraduate Award at the University of Sydney. C O’Callaghan is supported by an Alzheimer’s Australia PhD Scholarship at the University of New South Wales. M Gilat is supported by an International Postgraduate Research Scholarship at the University of Sydney. SL Naismith is supported by an NHMRC Career Development Award No. 1008117. SJG Lewis is supported by an NHMRC Practitioner Fellowship No. 1003007. JM Shine, JM Hall, L Mowszowski and JYY Szeto have no financial disclosures.

Conflicts of interest

The authors declare no conflict of interest.

Ethical standard

This study has been approved by the appropriate ethics committee and has therefore been performed in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki.

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Authors and Affiliations

  1. Parkinson’s Disease Research Clinic, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia

    Courtney C. Walton, James M. Shine, Julie M. Hall, Loren Mowszowski, Moran Gilat, Jennifer Y. Y. Szeto, Sharon L. Naismith & Simon J. G. Lewis

  2. Healthy Brain Ageing Program, Brain and Mind Research Institute, University of Sydney, Sydney, NSW, Australia

    Courtney C. Walton, Loren Mowszowski & Sharon L. Naismith

  3. Neuroscience Research Australia and School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia

    Claire O’Callaghan

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  1. Courtney C. Walton
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Correspondence to Simon J. G. Lewis.

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Walton, C.C., Shine, J.M., Hall, J.M. et al. The major impact of freezing of gait on quality of life in Parkinson’s disease. J Neurol 262, 108–115 (2015). https://doi.org/10.1007/s00415-014-7524-3

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