Fatigue in people with Parkinson's disease - its scale and consequences for activity and quality of life

Fatigue is one of the most common and distressing non-motor symptoms in Parkinson's disease, affecting up to half of patients. As a multidimensional symptom - encompassing physical, emotional, and cognitive aspects - it significantly reduces quality of life and daily functioning. It often appears in the early stages of the disease, and its subjective nature complicates its clear clinical definition. Despite its importance, fatigue is often underdiagnosed and rarely considered in routine care.

Fatigue in Parkinson's disease is often an underestimated symptom, despite its significant impact on quality of life and daily functioning, often more so than motor symptoms. Its impact on physical activity - a key factor in slowing disease progression - underscores the need to better recognize and incorporate this symptom into clinical practice. The study results may support the development of more effective and personalized therapeutic strategies.

The study included 107 patients with Parkinson's disease (PD), with Hoehn and Yahr scale (H&Y) disease stages I [n = 13 (12%)], II [n = 15 (14%)], III [n = 53 (50%)], and IV [n = 25 (23%)]; ages ranged from 35 to 86 years; and disease duration ranged from 0 to 33 years (Median = 7.00 years). The study tool was a questionnaire. Fatigue levels were assessed using two scales: the Parkinson's fatigue scale (PFS-16) and the fatigue severity scale (FSS). Physical activity and quality of life were examined with the Parkinson's disease questionnaire (PDQ-39).

The questionnaires used (FSS, PFS, PDQ-39) demonstrated high reliability (Cronbach's alpha: 0.93-0.96) and no floor/ /ceiling effects. Fatigue was reported in 57% of the participants, slightly more often in women, although the differences were not statistically significant. Disease duration was significantly longer in men (p < 0.01). Fatigue correlated with activity level (p < 0.01) and quality of life across all PDQ-39 domains.

Fatigue is a common and significant problem across all stages of Parkinson's disease. The FSS, PFS, and PDQ-39 questionnaires are reliable tools for assessing fatigue in people with PD. Fatigue has a significant impact on quality of life and activity levels. Further, multifaceted research is needed to clarify this issue.