LAUSR

The relationship quality, mutuality, has been identified as a protective factor in family care situations, but its role in mediating health-related quality of life (HRQoL) in patients having Parkinson's disease (PD) is not known. Data on patients' and partners' mutuality (MS), motor signs (UPDRS III), non-motor symptoms (NMSQuest), impaired cognition (IQCODE), dependency in activities of daily life (ADL), and HRQoL (PDQ8) were collected from 51 dyads. Structural equation model with manifest variables was applied to explore if the MS score mediated the effect of UPDRS III, NMSQuest, IQCODE, and dependency in ADL on PDQ8. The results suggest that increasing severity of motor and non-motor symptoms decreases patients' mutuality which leads to worse HRQoL. Partners' mutuality mediated the effect of impaired cognition which in turn decreased patients' mutuality. The findings enhance our understanding of how various symptoms may influence PD patients' HRQoL. This may help clinicians to personalize interventions to provide more effective interventions to improve the lives of patients with PD.