Prevalent Parkinson's Disease Research Articles

Care requirements of a prevalent population of people with idiopathic Parkinson's disease

Parkinson's disease (PD) is the second most common neurodegenerative condition in the UK. Care needs increase as the disease progresses, but there are very few published data in relation to this. the aim of this study was to elicit the care requirements for a prevalent PD population and compare these to a similarly aged background population. all people diagnosed with idiopathic PD from within a defined area of north-east England were asked to participate in this study. Those who agreed to participate were assessed using a number of standard rating scales including Hoehn and Yahr stage, Unified Parkinson's Disease Rating Scale (UPDRS), Hospital Anxiety and Depression Scale, Parkinson's Disease Questionaire-39 and Mini-Mental State Examination (MMSE). In addition, participants were asked whether they had experienced hallucinations. Social and demographic information (e.g. age, sex and place of abode) was also recorded. from all cases (n = 161), 135 people (83.8%) agreed to participate. Of these, 19 (14.1%) were living in residential or nursing homes, representing 1.6% of the total nursing/residential home residents in the study area. Participants had a mean age of 74.8 years and disease duration of 5.6 years. Those in care were significantly older and had significantly poorer Hoehn and Yahr, MMSE and UPDRS scores. PD patients in institutional care have poorer cognitive function, are older, have later stage disease and worse functional ability than those living at home.

Parkinson's disease and functional decline in older Mexican Americans

The purpose of this study was to establish prevalence and five-year incidence, and explore functional decline among older Mexican Americans with Parkinson's disease (PD). Using data from the Hispanic EPESE, baseline characteristics were compared across PD response profiles. Weighted generalized estimating equations (GEE) modeled the association between PD and outcomes. Prevalence was 1.30%; incidence at wave 4 was 1.18%. Those with prevalent PD had worse function than those without PD at each wave. Progressive functional decline across time was observed among those with PD. Older Mexican Americans with PD often live in the community, and those who provide care for them may be overburdened.

Pesticide Exposure and Self-reported Parkinson's Disease in the Agricultural Health Study

Previous studies based on limited exposure assessment have suggested that Parkinson's disease (PD) is associated with pesticide exposure. The authors used data obtained from licensed private pesticide applicators and spouses participating in the Agricultural Health Study to evaluate the relation of self-reported PD to pesticide exposure. Cohort members, who were enrolled in 1993-1997, provided detailed information on lifetime pesticide use. At follow-up in 1999-2003, 68% of the cohort was interviewed. Cases were defined as participants who reported physician-diagnosed PD at enrollment (prevalent cases, n = 83) or follow-up (incident cases, n = 78). Cases were compared with cohort members who did not report PD (n = 79,557 at enrollment and n = 55,931 at follow-up). Incident PD was associated with cumulative days of pesticide use at enrollment (for highest quartile vs. lowest, odds ratio (OR) = 2.3, 95% confidence interval: 1.2, 4.5; p-trend = 0.009), with personally applying pesticides more than half the time (OR = 1.9, 95% confidence interval: 0.7, 4.7), and with some specific pesticides (ORs > or = 1.4). Prevalent PD was not associated with overall pesticide use. This study suggests that exposure to certain pesticides may increase PD risk. Findings for specific chemicals may provide fruitful leads for further investigation.

The frequency and validity of self-reported diagnosis of Parkinson's Disease in the UK elderly: MRC CFAS cohort.

BackgroundEstimates of the incidence and prevalence of chronic diseases can be made using established cohort studies but these estimates may have lower reliability if based purely on self-reported diagnosis.MethodsThe MRC Cognitive Function & Ageing Study (MRC CFAS) has collected longitudinal data from a population-based random sample of 13004 individuals over the age of 65 years from 5 centres within the UK. Participants were asked at baseline and after a two-year follow-up whether they had received a diagnosis of Parkinson's disease. Our aim was to make estimates of the incidence and prevalence of PD using self-reporting, and then investigate the validity of self-reported diagnosis using other data sources where available, namely death certification and neuropathological examination.ResultsThe self-reported prevalence of Parkinson's disease (PD) amongst these individuals increases with age from 0.7% (95%CI 0.5–0.9) for 65–75, 1.4% (95%CI 1.0–1.7) for 75–85, and 1.6% (95%CI 1.0–2.3) for 85+ age groups respectively. The overall incidence of self reported PD in this cohort was 200/100,000 per year (95%CI 144–278). Only 40% of the deceased individuals reporting prevalent PD and 35% of those reporting incident PD had diagnoses of PD recorded on their death certificates. Neuropathological examination of individuals reporting PD also showed typical PD changes in only 40%, with the remainder showing basal ganglia pathologies causing parkinsonism rather than true PD pathology.ConclusionSelf-reporting of PD status may be used as a screening tool to identify patients for epidemiological study, but inevitably identifies a heterogeneous group of movement disorders patients. Within this group, age, male sex, a family history of PD and reduced cigarette smoking appear to act as independent risk factors for self-reported PD.

Excessive daytime sleepiness and subsequent development of Parkinson disease

To determine if excessive daytime sleepiness (EDS) can predate future Parkinson disease (PD). EDS was assessed in 3,078 men aged 71 to 93 years in the Honolulu-Asia Aging Study from 1991 to 1993. All were free of prevalent PD and dementia. Follow-up for incident PD was based on three repeat neurologic assessments from 1994 to 2001. During the course of follow-up, 43 men developed PD (19.9/10,000 person-years). After age adjustment, there was more than a threefold excess in the risk of PD in men with EDS vs men without EDS (55.3 vs 17.0/10,000 person-years; odds ratio [OR] = 3.3; 95% CI = 1.4 to 7.0; p = 0.004). Additional adjustment for insomnia, cognitive function, depressed mood, midlife cigarette smoking and coffee drinking, and other factors failed to alter the association between EDS and PD (OR = 2.8; 95% CI = 1.1 to 6.4; p = 0.014). Other sleep related features such as insomnia, daytime napping, early morning grogginess, and frequent nocturnal awakening showed little relation with the risk of PD. Excessive daytime sleepiness may be associated with an increased risk of developing Parkinson disease.

Prevalence of Parkinson's disease in lower Aragon, Spain.

We attempted to measure the prevalence of Parkinson's disease (PD) and to improve PD diagnosis in Lower Aragon (LA), a rural area located in northeast Spain with an elderly population numbering 60,724. Hospital records and a questionnaire targeted at general practitioners and retirement home personnel were used for case finding. Neurologic diagnoses were ascertained by a neurologist using a clinicoepidemiologic protocol and established diagnostic criteria after examining 84% of patients diagnosed with PD. Using stratified analysis, a comparison was run against reported PD prevalence from worldwide door-to-door surveys. On the prevalence date, 134 individuals were found to be affected with PD. The prevalence per 100,000 population was 220.6 (crude) and 121.9 when age-adjusted using the European Standard Population. Prevalence increased with age, declining at 90 years and over. Questionnaires returned by general practitioners disclosed 20% of the prevalent PD cases. The prevalence of PD in pooled European populations was 2.56 times (95% confidence interval [CI]: 2.02-3.24) greater than that found in our study. PD prevalence in Lower Aragon ranks at levels similar to those reported for white populations (European and non-European). One out of two individuals with PD was estimated to be undiagnosed before and three out of eight after the study.