Fatigue and related factors in patients with Parkinson's disease

Background: While fatigue ranks as one of the most common symptoms of Parkinson's disease (PD), few studies on PD-related fatigue have been done in Taiwan. Purpose: The purpose of this study was to explore PD fatigue and fatigue-related factors. Methods: A descriptive and correlation study design was used. Using purposive sampling, we recruited 100 subjects from a medical center in northern Taiwan. Data were analyzed using Pearson product-moment correlation, independent t-test, chi-square test, one way ANOVA, multiple regression and logistic regression. Results: Results showed that: (1) about 46% of participants reported fatigue symptoms; (2) UPDRS (Unified Parkinson's Disease Rating Scale) total score, Hoehen and Yahr stage (H&Y), daily L-dopa dose (mg), quality of sleep and depression symptoms each correlated positively with level of fatigue. The Schwab and England score (SES) correlated negatively with level of fatigue; (3) depression inclination explained 45.0% of variance in fatigue among subjects; (4) depression inclination was a significant fatigue predictor (OR = 5.357, 95% CI = 2.27-12.65) among participants. Conclusion: Fatigue associated with PD is a common and under-appreciated problem. The present study confirms UPDRS total score, HYS, daily L-dopa dose (mg), quality of sleep, depression symptoms and SES to correlate positively with level of fatigue. Assessment of fatigue should be part of the routine evaluation procedures used with PD patients to promote healthcare quality.