Non motor symptoms in patients with Parkinson disease: experience from a tertiary care center in Sri Lanka

Non motor symptoms (NMS) of Parkinson’s disease (PD) lead to morbidity, impaired quality of life and frequent hospitalization. NMS are under-recognized and under-reported. NMS Quest is a validated screening tool adopted to identify these symptoms in patients with PD. We conducted a descriptive cross sectional study during March 2012 – September 2012 in a tertiary care hospital in Sri Lanka to describe the non-motor symptoms of PD and to determine the percentage of NMS that remain undeclared to the healthcare professionals. 103 patients, age 64.55 (SD 9.62, range 43-86) years, 58 (56.3%) males and 45 (43.7%) females completed the study. Mean duration of illness was 3.16 yrs. 98.1% of patients had at least one NMS. The mean total NMSQ-T was 9.08 +/- 5.087(SD). Memory loss was the commonest NMS. NMSQ-T increased with the severity of PD (p<0.001) but no association was found between NMSQ-T and age, sex or duration of illness. Loss of weight, difficulty in swallowing and falls were significantly commoner among males than females. (p <0.05) A significant proportion of NMS (Mean 76.1 +/- 17.7, range 36.7% to 100%) were undeclared to the health care personnel. Incomplete bowel evacuation, sweating, diplopia and anxiety were the least declared symptoms. In conclusion, NMS are present in the majority of patients with PD increasing with the severity of disease. A significant proportion of NMS are undeclared to the healthcare personnel highlighting the importance of using screening tools to identify these symptoms during health visits.