Motor and non-motor symptoms of 1453 patients with Parkinson's disease: Prevalence and risks

https://doi.org/10.1016/j.parkreldis.2013.04.001Get rights and content
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Abstract

Purpose

We examined the prevalence and risk of clinical symptoms in a large number of Japanese patients with Parkinson's disease (PD) (n = 1453; 650 males).

Methods

Events were analyzed using Kaplan–Meier survival curves, logistic regression, and Cox proportional-hazards models.

Results

The mean age (SD) was 67.7 (10.0), age of onset was 58.0 (11.5), and disease duration was 9.7 (6.6) years. The mean modified Hoehn and Yahr stage was 2.8 (1.2). Most patients (88.9%) received levodopa (547.7 (257.6) mg/day). A large proportion (81.3%) received dopamine agonists (136.2 (140.7) mg/day). About 23.4% received pain treatment 6.9 (5.1) years after the onset; females (p < 0.05) and patients with late-onset PD (≥60 years, p < 0.001) were more likely to be affected. About 44.7% of patients had wearing-off 7.5 (4.7) years after the onset, and it was more common in females (p < 0.001) and patients with early-onset PD (p < 0.001). Camptocormia was found in 9.5% of patients 8.1 (6.2) years after the onset, and it was more common in females (p < 0.05) and patients with late-onset PD (p < 0.05). About 28.6% of patients developed psychosis 9.0 (5.4) years after the onset, and it was more likely to occur in patients with late-onset PD (p < 0.001). Late-onset PD and cerebrovascular disease were also associated with increased risk of pneumonia.

Conclusions

Considering that very few studies have assessed numerous clinical symptoms in the same report, these data provide a useful reference for the clinical course of PD.

Keywords

Parkinson's disease
Natural history studies
Wearing-off
Camptocormia
Psychosis

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Editor's comment: By systematically obtaining information from the charts of an impressively large number of patients with Parkinson's disease (PD) followed in an outpatient neurology clinic, Yoritaka and colleagues have provided us a treasure trove of information and data that will serve as a valuable reference point for both clinicians and researchers. In addition to useful demographic and treatment information, they also have accumulated very interesting data on a number of aspects of PD that often receive scant attention, such as the frequency of camptocormia and pneumonia in PD patients.

Ronald F. Pfeiffer, Editor-in-Chief Department of Neurology, University of Tennessee HSC, 875 Monroe Avenue, Memphis, TN 38163, USA