The late stage of Parkinson's –results of a large multinational study on motor and non-motor complications
Schrag, A. ; Hommel, A. L.A.J. ; Lorenzl, S. ; Meissner, W. G. ; Odin, P. LU
; Coelho, M.
; Bloem, B. R.
and Dodel, R.
(2020)
In Parkinsonism and Related Disorders
75.
p.91-96
- Abstract
Introduction: There is little information on the late stages of parkinsonism. Methods: We conducted a multicentre study in 692 patients with late stage parkinsonism in six European countries. Inclusion criteria were disease duration of ≥7 years and either Hoehn and Yahr stage ≥4 or Schwab and England score of 50 or less. Results: Average disease duration was 15.4 (SD 7.7) years and mean total UPDRS score was 82.7 (SD 22.4). Dementia according to MDS-criteria was present in 37% of patients. Mean levodopa equivalence dose was 874.1 (SD 591.1) mg/d. Eighty two percent of patients reported falls, related to freezing (16%) or unrelated to freezing (21% of patients) or occurring both related and unrelated to freezing (45%), and were frequent... (More)
Introduction: There is little information on the late stages of parkinsonism. Methods: We conducted a multicentre study in 692 patients with late stage parkinsonism in six European countries. Inclusion criteria were disease duration of ≥7 years and either Hoehn and Yahr stage ≥4 or Schwab and England score of 50 or less. Results: Average disease duration was 15.4 (SD 7.7) years and mean total UPDRS score was 82.7 (SD 22.4). Dementia according to MDS-criteria was present in 37% of patients. Mean levodopa equivalence dose was 874.1 (SD 591.1) mg/d. Eighty two percent of patients reported falls, related to freezing (16%) or unrelated to freezing (21% of patients) or occurring both related and unrelated to freezing (45%), and were frequent in 26%. Moderate-severe difficulties were reported for turning in bed by 51%, speech by 43%, swallowing by 16% and tremor by 11%. Off-periods occurred in 68% and were present at least 50% of the day in 13%, with morning dystonia occurring in 35%. Dyskinesias were reported by 45% but were moderate or severe only in 7%. Moderate-severe fatigue, constipation, urinary symptoms and nocturia, concentration and memory problems were encountered by more than half of participants. Hallucinations (44%) or delusions (25%) were present in 63% and were moderate-severe in 15%. The association with overall disability was strongest for severity of falls/postural instability, bradykinesia, cognitive score and speech impairment. Conclusion: These data suggest that current treatment of late stage parkinsonism in the community remains insufficiently effective to alleviate disabling symptoms in many patients.
(Less)
- author
- Schrag, A.
; Hommel, A. L.A.J.
; Lorenzl, S.
; Meissner, W. G.
; Odin, P.
LU
; Coelho, M.
; Bloem, B. R.
and Dodel, R.
- author collaboration
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Disability, Late-stage parkinsonism, Motor features, Non-motor symptoms, Prevalence
- in
- Parkinsonism and Related Disorders
- volume
- 75
- pages
- 6 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85085597017
- pmid:32505085
- ISSN
- 1353-8020
- DOI
- 10.1016/j.parkreldis.2020.05.016
- language
- English
- LU publication?
- yes
- id
- 55dc9a4c-c8bd-4d89-86c0-488ee4d32be8
- date added to LUP
- 2020-06-12 14:26:58
- date last changed
- 2024-06-26 16:31:26
@article{55dc9a4c-c8bd-4d89-86c0-488ee4d32be8,
abstract = {{<p>Introduction: There is little information on the late stages of parkinsonism. Methods: We conducted a multicentre study in 692 patients with late stage parkinsonism in six European countries. Inclusion criteria were disease duration of ≥7 years and either Hoehn and Yahr stage ≥4 or Schwab and England score of 50 or less. Results: Average disease duration was 15.4 (SD 7.7) years and mean total UPDRS score was 82.7 (SD 22.4). Dementia according to MDS-criteria was present in 37% of patients. Mean levodopa equivalence dose was 874.1 (SD 591.1) mg/d. Eighty two percent of patients reported falls, related to freezing (16%) or unrelated to freezing (21% of patients) or occurring both related and unrelated to freezing (45%), and were frequent in 26%. Moderate-severe difficulties were reported for turning in bed by 51%, speech by 43%, swallowing by 16% and tremor by 11%. Off-periods occurred in 68% and were present at least 50% of the day in 13%, with morning dystonia occurring in 35%. Dyskinesias were reported by 45% but were moderate or severe only in 7%. Moderate-severe fatigue, constipation, urinary symptoms and nocturia, concentration and memory problems were encountered by more than half of participants. Hallucinations (44%) or delusions (25%) were present in 63% and were moderate-severe in 15%. The association with overall disability was strongest for severity of falls/postural instability, bradykinesia, cognitive score and speech impairment. Conclusion: These data suggest that current treatment of late stage parkinsonism in the community remains insufficiently effective to alleviate disabling symptoms in many patients.</p>}},
author = {{Schrag, A. and Hommel, A. L.A.J. and Lorenzl, S. and Meissner, W. G. and Odin, P. and Coelho, M. and Bloem, B. R. and Dodel, R.}},
issn = {{1353-8020}},
keywords = {{Disability; Late-stage parkinsonism; Motor features; Non-motor symptoms; Prevalence}},
language = {{eng}},
pages = {{91--96}},
publisher = {{Elsevier}},
series = {{Parkinsonism and Related Disorders}},
title = {{The late stage of Parkinson's –results of a large multinational study on motor and non-motor complications}},
url = {{http://dx.doi.org/10.1016/j.parkreldis.2020.05.016}},
doi = {{10.1016/j.parkreldis.2020.05.016}},
volume = {{75}},
year = {{2020}},
}