Author/Editor		Rečnik, Gregor; Avberšek, Andreja
Title		Kako izboljšati kvaliteto življenja pri bolnikih s parkinsoizmom?
Translated title		How to improve the quality of life of people with Parkinsonism?
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 42, št. 1
Publication year		2003
Volume		str. 3-16
Language		slo
Abstract		Parkinsonism is a ehronic disorder of the central nervous system characterized pathologically by degeneration of dopamine neurons in substantia nigra pars compacta. Consequently, striatal dopamine levels decrease resulting in classical motor signs (tremor, rigidity, akinesia, postural impairment). Recently, pathological changes have been described also in limbic and prefrontal cortices which may explain non-motor parkinsonian symptoms (dementia, depression). As yet there has been no study in Slovenia on how various factors influence quality of life (QoL) in Parkinsonian patients. 71 patients were asked to assess quality of their life on a visual analogue scale and with EQ-5D instrument. According to the results on the VAS they were divided into two groups. The following parameters were studied in all patients: motor disability, impairment in daily activities, cognitive abilities, depression and self-assessment of their health state. Depression was assessed in carers. Our results show that depression and impairment in daily activities, but not motor or cognitive disability, influence, QoL in patients with parkinsonism. We propose that clinical examination of the patients includes not only motor assessment but also assessment of mood in patients and occasionally carers. Improvement in daily activities can be reached with a multidisciplinary team management of the patient.
Summary		Patomorfološka osnova parkinsonizma je propadanje dopaminskih nevronov v kompaktnem delu črne substance, kar povzroči pomanjkanje dopamina v striatumu. To privede do nastanka klasičnih motoričnih znakov (tremor, rigidnost, akinezija, motnje ravnotežja). V zadnjih desetletjih pa patologi opisujejo tudi spremembe v limbičnem in prefrontalnem korteksu, ki povzročajo nemotorične simptome (demenca, depresija). Na področju Slovenije ni bila izvedena še nobena študija o vplivu različnih dejavnikov na kvaliteto življenja bolnikov s parkinsonizmom. 71 oseb s parkinsonizmom je kvaliteto življenja ocenilo na vidni analogni lestvici in s testom EQ 5D. Na osnovi ocene na vidni analogni lestvici sva oblikovala dve skupini. Pri preiskovancih obeh skupin sva ocenjevala motorično prizadetost, zmožnost opravljanja vsakodnevnih aktivnosti, spoznavne sposobnosti, prisotnost depresivnosti in dojemanje lastnega zdravja, pri skrbnikih pa prisotnost depresivnosti. Pokazala sva, da sta pomembna dejavnika, ki vplivata na kvaliteto življenja, depresivnost bolnika in zmožnost opravljanja vsakodnevnih aktivnosti, ne pa motorične težave ali spoznavne sposobnosti. Predlagava, da se pri kliničnem pregledu bolnika s parkinsonizmom preverjanje motorike dopolni z ocenjevanjem depresivnosti. Opravljanje vsakodnevnih aktivnosti lahko izboljšamo z multidisciplinarnim timskim pristopom.
Descriptors		PARKINSON DISEASE QUALITY OF LIFE ACTIVITIES OF DAILY LIVING MOVEMENT DISORDERS NEUROLOGIC EXAMINATION PAIN DEPRESSION QUESTIONNAIRES