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Ten years ago, we examined 30 patients with Hoehn-Yahr stage III Parkinson disease (PD) to determine predictors related to falling, including walking speed, step number, and step time by using the originally designed narrowed paths. We verified the increased number of steps as greater risk for an upgrade of Hoehn-Yahr stage in a 6-year period. We further prospectively studied the same patients whether the step number on a sudden narrow path persists as a predictor of the severity of PD.
The follow-up patients were divided into 2 groups-patients with and without an increase in Hoehn-Yahr stage. Variables with a significant relation to the development of Hoehn-Yahr stage on a single variable logistic regression analysis (
< 0.05) were entered into multiple logistic regression analysis, adjusting both age and disease duration.
The significant variables between patients with and without an increase in Hoehn-Yahr stage were 36-item Short-Form Health Survey (SF-36) scores at 2, 4, 6, and 8 years. Multiple logistic regression analyses after adjusting both age and disease duration showed the SF-36 score at 2, 4, 6, and 8 years. The domain in social functioning significantly differed between patients with and without deterioration of Hoehn-Yahr stage in 10 years.
This study demonstrated the capacity of low health-related quality of life (HR-QOL) to predict future developments of PD staging in 10 years. The lower HR-QOL, particularly in social functioning, may reflect the severity of both motor and nonmotor symptoms.