Quality-of-life repercussions and costs of parkinson's disease
This paper aims to assess the impact of Parkinson's disease from the perspective of the patient and carer, and to discuss the potential financial costs of the disease to society as a whole as well as to those who live with it on a day-to-day basis. As the population ages, neurological disorders such as Parkinson's disease have become increasingly prevalent. Consequently, it is essential that the impact of such disorders is well understood. Traditionally, Parkinson's disease has been assessed in terms of patient symptoms and the consequent effects of treatment regimens upon them. However, such symptom-based evaluations can provide only a very narrow understanding of the disease and, more recently, attempts have been made to measure the health-related quality of life of patients. Such assessments, using both generic and disease-specific instruments, suggest that the disease has wider consequences for patients than are accounted for by clinical scales, with patients, for example, expressing embarrassment and feeling stigmatised because of their condition. Furthermore, the disease can have substantial effects upon those who care for patients: evidence suggests that carers experience much greater levels of depression and physical ill health than age-matched control groups. However, the demands of the illness are not restricted to patients and carers. The costs to society, in terms of treatment and early retirement because of the disease, are substantial, yet economic assessment of the impact of Parkinson's disease remains in its infancy. The paper concludes by suggesting that future trials of treatment regimens must incorporate assessments of the health-related quality of life of patients and carers as well as carefully conducted economic assessments.