Parkinson's Disease Progression Highly Variable
Jul 05, 2013
Drug & Reference Information
- Deep Brain Stimulation for Parkinson Disease
- Parkinson Disease and LRRK2
- Stereotactic Surgery in Parkinson Disease
SYDNEY — Progression of Parkinson's disease (PD) can be highly variable, and dementia, psychosis, and dysphagia are not invariable features of the disease, even when disease duration is longer than 30 years, researchers from Italy have observed.
The few studies that have described the long-term clinical course of PD have reported data only up to 20 years of disease duration, and those studies had small samples sizes, until now.
At the Movement Disorder Society (MDS) 17th International Congress of Parkinson's Disease and Movement Disorders, Roberto Cilia, MD, and colleagues at the Parkinson Institute in Milan, Italy, reported data on motor and nonmotor features of PD in a large cohort of patients 20 years – and in some cases 30 years – from diagnosis.
The retrospective cross-sectional study included all consecutive PD outpatients with disease duration beyond 20 years attending their center from 1998 until September 2012. A total of 320 patients had PD for 20 to 22 years, 168 had PD for 23 to 25 years, 89 patients for 26 to 28 years, and 50 had PD for 29 years or longer.
The researchers report that disease progression "may be extremely variable; it may be slow-progressing" with only 50% of patients in Hoehn & Yahr stage greater than 4 at 30 years after diagnosis.
And although postural instability is an invariable feature of advanced PD (seen in all patients at 30 years), this is not true for falls, probably because of preventive strategies such as use of wheelchairs, they note.
Dementia also does not appear to be an invariable feature of late-stage PD, according to this study. "The prevalence of dementia remains about 30% to 35% over 20 years, including those over 30 years from the PD onset," Dr. Cilia told Medscape Medical News.