D'Iorio A, et al. – The authors undertook this study to investigate the effect of specific non–motor symptoms on the Health–related quality of life (HRQoL) in Parkinson's disease (PD). They demonstrated that in PD, anxiety, apathy associated with impaired planning, attention, and organization (i.e., executive apathy evaluated by the Dimensional Apathy Scale) and reduced functional autonomy contributed significantly to reduce the HRQoL. Hence, early identification and management of these neuropsychiatric symptoms was found to be relevant to preserve HRQoL in PD.

• To evaluate depression, apathy, impulse control disorders (ICD), anxiety, anhedonia and functional impact of the cognitive impairment, 84 outpatients underwent the Montreal Cognitive Assessment (MoCA) assessing global functioning and several questionnaires.
• The authors assessed the perceived QoL by Parkinson's Disease Questionnaire (PDQ-8).
• They divided the PD sample into patients with high and low HRQoL around the median of PDQ-8 and compared on clinical features, cognitive and neuropsychiatric variables.
• They applied a linear regression analysis, in which the global functioning, apathy, depression, anxiety, anhedonia, ICD and the functional autonomy scores were entered as independent variables and PDQ-8 score as the dependent variable.

• Compared to patients with high HRQoL, patients with lower HRQoL were more depressed, apathetic, anxious and showed a more severe reduction of functional autonomy and global functioning.
• The regression analysis demonstrated that factors significantly correlated with a higher score on PDQ-8 were a higher level of anxiety, executive apathy, and more reduced functional autonomy.