Population-based case-control study of morale in Parkinson's disease

Background: Parkinson's disease (PD) is associated with cognitive, psychiatric, and motor features. Each could contribute to a poor sense of well-being and low morale. A systematic study of morale in community-dwelling PD cases has not been performed. Methods: A total of 52 PD cases and 260 matched controls from three Spanish communities were assessed using the Philadelphia Geriatric Center Morale Scale (PGCMS) (range = 0[low morale]-17). The PGCMS includes three dimensions of psychological well-being: agitation, lonely dissatisfaction, and attitude toward own aging. Results: The PGCMS score was lower in PD cases than controls (8.71 ± 3.64 vs. 11.03 ± 2.77, P < 0.001), as were the agitation subscore (3.36 ± 1.91 vs. 4.07 ± 1.59, P < 0.05), lonely dissatisfaction subscore (3.48 ± 1.36 vs. 4.11 ± 1.12, P < 0.01), and attitude toward own aging subscore (1.86 ± 1.37 vs. 2.85 ± 1.13, P < 0.001). In a linear regression analysis that adjusted for depressive symptoms and other covariates, PD cases had a lower PGCMS score than controls (P < 0.001). Conclusions: Morale was significantly lower in community-dwelling PD cases than matched controls. The detection and possible treatment of this problem may improve the psychological well-being of patients with this disease.