Effect of freezing of gait on quality of life in patients with Parkinson’s disease

Abstract BACKGROUND: Parkinson’s disease (PD) is a chronic neurodegenerative condition that affects not just movements but also many nonmotor aspects of the body. Freezing of gait (FOG) is a devastating symptom that occurs several years after PD motor symptoms appear. It is an incapacitating clinical symptom marked by brief spells of being unable to move forward or by taking several small steps in quick succession, usually happening at the start of gait (gait ignition difficulty) or while turning. Quality of life (QoL) in a person with PD (PwP) depends on several variables, namely age of onset of PD, female gender, depression, and many more. In this study, we aim to determine whether the QoL of PwP is related to FOG. We hypothesize that PwP who have FOG, i.e., PDF+ (PwP with freezing), will have considerably reduced QoL as compared to PDF− (PwP without freezing). MATERIAL AND METHODS: In this retrospective cross-sectional study, we included 50 PwP with FOG (PDF+) and 50 PwP without FOG (PDF−), irrespective of current age, age of onset of disease, duration of disease, and gender, based on UK PD Brain Bank clinical diagnostic criteria. Patients with other medical or orthopedic conditions affecting gait and those not satisfying UK PD Brain Bank clinical diagnostic criteria for PD were excluded. To test QoL, we administered the PD Questionnaire-8 (PDQ-8) in the medical ON phase to all participants. RESULT: The participants in our study were well matched with regard to male-to-female ratio, mean age (±standard deviation SD) years, and mean (±SD) disease duration in years. PDQ-8 had adequate internal consistency (PDQ-8 total Cronbach’s α: 0.75; intraclass correlation coefficient, p < 0.001; 95% confidence interval: 0.6–0.8). CONCLUSION: PwP with FOG had significantly poorer QoL compared to those without FOG in all aspects of QoL, namely reduced mobility, emotional well-being, stigma, social support, communication, and physical discomfort, irrespective of other confounding factors. However, the activity of daily living and cognition aspects of QoL were not affected by FOG in PwP.