OBJECTIVES: Parkinson's Disease (PD) is a progressive neurodegenerative disorder characterized by worsening symptoms over time. The focus of this study is to analyze changes in the Health-Related Quality of Life (HRQoL) among patients with PD following a 6-month treatment regimen involving supplements containing vitamin B12 (5 µg), folic acid (1000 µg), and vitamin D3 (800 IU).

METHODS: The present study was a multicenter, hospital-based observational study conducted in Romania. We assessed the baseline and post-6-month treatment levels of homocysteine. HRQoL was evaluated using the 15D instrument, which explores 15 dimensions, including mobility, vision, hearing, breathing, sleeping, eating, speech, excretion, usual activities, mental function, discomfort and symptoms, depression, distress, vitality, and sexual activity. An important clinical improvement in HRQoL, characterized as "much better," is a minimum important difference of 0.035 in the 15D scores from baseline.

RESULTS: A total of 24 patients with PD, treated with levodopa/carbidopa, were recruited. Dietary intake was assessed at baseline and after 6 months of treatment (1 tablet daily). Homocysteine levels showed a significant reduction from a mean±SD of 19.73±5.5 μmol/L at baseline to 15.44±3.8 μmol/L (p=0.0049). Furthermore, a noteworthy improvement in the HRQoL was observed after 6 months of treatment (p=0.0246), specifically in the dimensions of speech (p=0.0126), mental function (p=0.0230), discomfort and symptoms (p=0.0024), and depression (p=0.0053). Importantly, a "much better" clinical change was noted for all these dimensions and overall HRQoL.

CONCLUSIONS: In the current observational study, the supplementation of vitamin B12, vitamin D, and folic acid proved effective in lowering elevated homocysteine concentrations resulting from levodopa metabolism. The administration of vitamin B12, vitamin D, and folic acid supplements is recommended concurrently with the initiation of levodopa to mitigate hyperhomocysteinemia and improve health-related quality of life (HRQoL), particularly in the aspects of speech, mental function, discomfort, and depression.