Perbandingan kualitas hidup pasien Parkinson subtipe tremor dominant dan postural instability gait disorder

https://doi.org/10.22146/bns.v19i1.61891

Marissa Ayu Anindyta(1*), Sri Sutarni(2), Indarwati Setyaningsih(3)

(1) KSM Saraf, RSUD Kota Banjar, Jawa Barat
(2) Departemen Neurologi, Fakultas Kedokteran-Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada, Yogyakarta
(3) Departemen Neurologi, Fakultas Kedokteran-Kesehatan Masyarakat dan Keperawatan Universitas Gadjah Mada, Yogyakarta
(*) Corresponding Author

Abstract


Parkinson's disease is a progressive neurodegenerative disease with varied motoric and non-motoric symptoms. The prevalence and incidence of Parkinson's disease increase with age. Common subtypes of Parkinson's disease (PD) are tremor dominant subtypes and postural instability gait disordersubtypes.. Both of these subtypes differ in clinical, imaging, genetic, and pathological features. This study aims to determine the quality of life (QoL) of PD patients with subtypes of tremor dominant (TD) and postural instability gait disorder (PIGD).

This was a cross-sectional study. We compared the QoL of 22 patients with tremor dominant and 22 with postural instability gait disorder in Dr. Sardjito hospital Yogyakarta, Dr. Soeradji Tirtonegoro hospital Klaten, and Tjitrowardojo hospital Purworejo. The QoL was assessed with the PDQ-39 questionnaire.

The results showed mean difference in PDQ-39 score in both subtypes of PD in which the QoL in TD was better than in PIGD (p <0.05). The significant differences were mainly in the mobility aspect (p <0.01) and the activities of daily living (p <0.01) in which the mean of PDQ-39 score was higher in the PIGD subtype compared with the TD subtype. Based on the results of multivariate analysis, only Parkinson’s subtypes (p <0.05) that significantly influence the QoL.

The QoL in TD subtype was significantly better than PIGD subtype.This has implications for the Parkinson's subtype management strategy. PIGD subtype Parkinson's disease which associated with lower QoL and faster disease progression needed comprehensive education about the prognosis and evaluation of motor and nonmotor symptoms.

 

ABSTRAK

 

Penyakit Parkinson merupakan penyakit neurodegeneratif progresif dengan gejala motorik dan nonmotorik yang bervariasi. Prevalensi dan insidensi penyakit Parkinson semakin meningkat seiring bertambahnya umur. Subtipe penyakit Parkinson yakni subtipe yang memiliki klinis tremor lebih dominan (tremor dominant) dan klinis instabilitas postural atau gait yang dominan (postural instability gait disorder). Kedua subtipe Parkinson tersebut memiliki perbedaan dalam hal klinis, imaging, genetik, dan tanda patologis. Penelitian ini bertujuan untuk mengetahui perbandingan kualitas hidup pasien Parkinson subtipe tremor dominant (TD) dan postural instability gait disorder (PIGD).

Penelitian ini merupakan penelitian potong lintang. Pada penelitian ini, dilakukan perbandingan kualitas hidup antara 22 pasien Parkinson subtipe TD dan 22 subtipe PIGD di poliklinik saraf RSUP Dr. Sardjito Yogyakarta, RSUP Dr. Soeradji Tirtonegoro Klaten, dan RSUD Tjitrowardojo Purworejo. Pemeriksaan kualitas hidup dinilai dengan kuesioner PDQ-39.

Hasil menunjukkan terdapatnya perbedaan rerata skor PDQ-39 pada kedua subtipe parkinson. Kualitas hidup subtipe TD lebih baik dibandingkan PIGD (p <0,05). Perbedaan bermakna terutama pada aspek mobilitas (p <0,01) dan activity daily living (p <0,01) dengan rerata skor PDQ-39 aspek tersebut lebih tinggi pada subtipe PIGD dibandingkan TD. Berdasarkan hasil analisis multivariat hanya faktor subtipe Parkinson (p <0,05) yang berpengaruh signifikan terhadap kualitas hidup.

Kualitas hidup subtipe TD lebih baik secara signifikan dibandingkan dengan subtipe PIGD. Hal ini berimplikasi pada strategi manajemen subtipe Parkinson. Penyakit Parkinson subtipe PIGD berhubungan dengan kualitas hidup yang lebih rendah dan progresivitas penyakit yang lebih cepat sehingga diperlukan edukasi mengenai prognosis serta evaluasi gejala motorik dan nonmotorik yang komprehensif.


Keywords


parkinson; tremor dominant; postural instability gait disorder; quality of life

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DOI: https://doi.org/10.22146/bns.v19i1.61891

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