Clinical Features in Early Parkinson Disease and Survival

Abstract

To examine the association between demographic and clinical features in early Parkinson disease (PD) and length of survival in a multiethnic population.Design: Clinical features within 2 years of diagnosis were determined for an inception cohort established during 1994-1995. Vital status was determined through December 31, 2005. Predictor variables included age at diagnosis, sex, race/ethnicity, as well as clinical subtype (modified tremor dominant, postural instability gait difficulty), symmetry, cognitive impairment, depression, dysphagia, and hallucinations. Cox proportional hazards regression analysis was used to identify factors associated with shorter survival.

Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients

“…PIGD subtype at onset was shown to have 2.1 times higher mortality, which was in line with many other studies 18 20. To date, the pathophysiology of maintenance of postural stability is not well understood.…”

“…Evidence shows that the PIGD subtype of PD at presentation not only confers worse survival18 20 but also an increased risk of dementia 26. Could this imply an earlier cholinergic deficit, apart from the dopaminergic deficit in this subtype, resulting in earlier dopa resistant postural instability and dementia, subsequently threatening survival in these patients?…”

Parkinson's disease dementia: convergence of α-synuclein, tau and amyloid-β pathologies

“…Indeed, the presence of cognitive impairment or dementia in PD patients is associated with a loss of independence, a lower quality of life and a reduction in survival time. 10, 11 Furthermore, individuals with end-stage PD who develop dementia often exhibit a decline in function that follows a stereotypical pattern, indicating that dementia onset may herald impending residential care and mortality. 4 Thus, the onset and progression of cognitive impairment and dementia in PD have an important influence on patient management and prognosis and understanding the pathophysiology underlying cognitive dysfunction in PD is critical for therapeutic development.…”

Association of cognitive domains with postural instability/gait disturbance in Parkinson's disease

“…Cognitive impairments in PD-MCI and PD-D are among the most consequential features of the disease, contributing to reduced quality of life [3] and increased risk for disability and mortality [4, 5]. …”