Clinical problems in non‐fluctuating patients with Parkinson's disease: A community‐based study
Identifieur interne : 004B05 ( Main/Exploration ); précédent : 004B04; suivant : 004B06Clinical problems in non‐fluctuating patients with Parkinson's disease: A community‐based study
Auteurs : Jan P. Larsen [Norvège] ; Karen Karlsen [Norvège] ; Elise Tandberg [Norvège]Source :
- Movement Disorders [ 0885-3185 ] ; 2000-09.
Descripteurs français
- Pascal (Inist)
- Wicri :
- geographic : Norvège.
- topic : Gestion, Personne âgée.
English descriptors
- KwdEn :
- Activity, Age of Onset, Aged, Antiparkinson Agents (adverse effects), Case-Control Studies, Complication, Daily living, Dementia (epidemiology), Dementia (etiology), Depression (epidemiology), Depression (etiology), Diabetes Mellitus (epidemiology), Disability, Drug Tolerance, Elderly, Fatigue (epidemiology), Fatigue (etiology), Female, Handicap, Humans, Levodopa (adverse effects), Male, Management, Movement Disorders (epidemiology), Movement Disorders (etiology), Neurologic Examination, Non‐fluctuators, Norway (epidemiology), Outpatients, Parkinson Disease (complications), Parkinson Disease (epidemiology), Parkinson Disease (physiopathology), Parkinson Disease (psychology), Parkinson disease, Parkinson's disease, Prevalence, Psychometrics, Psychomotor Performance, Quality of Life, Quality of life, Questionnaires, Severity of Illness Index, Sleep Disorders (epidemiology), Sleep Disorders (etiology).
- MESH :
- chemical , adverse effects : Antiparkinson Agents, Levodopa.
- geographic , epidemiology : Norway.
- complications : Parkinson Disease.
- epidemiology : Dementia, Depression, Diabetes Mellitus, Fatigue, Movement Disorders, Parkinson Disease, Sleep Disorders.
- etiology : Dementia, Depression, Fatigue, Movement Disorders, Sleep Disorders.
- physiopathology : Parkinson Disease.
- psychology : Parkinson Disease.
- Age of Onset, Aged, Case-Control Studies, Drug Tolerance, Female, Humans, Male, Neurologic Examination, Outpatients, Prevalence, Psychomotor Performance, Quality of Life, Questionnaires, Severity of Illness Index.
Abstract
OBJECTIVE: To investigate the frequency of non‐fluctuators in a community‐based prevalence study of Parkinson's disease (PD) and to describe disability, non‐motor problems, and health‐related quality of life in patients with PD with and without motor fluctuations, and compare the findings to those of two control groups. METHODS: The study involved 245 patients with PD who were participating in a prevalence study and two control groups (100 healthy elderly individuals and 100 patients with diabetes mellitus [DM]). Data were obtained through neurologic examination and a semistructured interview, and by the use of several questionnaires. RESULTS: In this group of unselected patients with PD, 78% did not experience motor fluctuations. Mean duration of treatment with levodopa was 6.3 years. Patients with motor fluctuations had a lower age at onset of disease, longer duration of disease, and a higher daily levodopa dose than patients without fluctuations. Among the non‐fluctuating patients, we found more dementia and a higher age at prevalence day. Disability (assessed by the Unified Parkinson's Disease Rating Scale subscales for activities of daily living and motor function and the Hoehn and Yahr stage) was similar in fluctuators and non‐fluctuators. Depression, sleep disturbances, and fatigue were equally frequent in both patient groups. The occurrence of these difficulties was clearly more frequent among non‐fluctuating patients with PD than among the control subjects. CONCLUSION: Most patients in the general population who have PD do not experience dose‐dependent motor fluctuations. Severity of motor disability and neuropsychiatric manifestations are as important in non‐fluctuators as in fluctuators. Patients without motor fluctuations have more depression, sleep disturbances, fatigue, and a poorer health‐related quality of life than patients with DM and healthy elderly individuals. This also underlines the importance of developing better management and treatment strategies for this group of patients with PD.
Url:
DOI: 10.1002/1531-8257(200009)15:5<826::AID-MDS1010>3.0.CO;2-E
Affiliations:
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Le document en format XML
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Larsen</name><affiliation wicri:level="1"><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Neurology, Central Hospital of Rogaland, Stavanger</wicri:regionArea><wicri:noRegion>Stavanger</wicri:noRegion></affiliation></author><author><name sortKey="Karlsen, Karen" sort="Karlsen, Karen" uniqKey="Karlsen K" first="Karen" last="Karlsen">Karen Karlsen</name><affiliation wicri:level="1"><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Neurology, Central Hospital of Rogaland, Stavanger</wicri:regionArea><wicri:noRegion>Stavanger</wicri:noRegion></affiliation></author><author><name sortKey="Tandberg, Elise" sort="Tandberg, Elise" uniqKey="Tandberg E" first="Elise" last="Tandberg">Elise Tandberg</name><affiliation wicri:level="1"><country xml:lang="fr">Norvège</country><wicri:regionArea>Department of Neurology, Central Hospital of Rogaland, Stavanger</wicri:regionArea><wicri:noRegion>Stavanger</wicri:noRegion></affiliation></author></analytic><monogr></monogr><series><title level="j">Movement Disorders</title><title level="j" type="abbrev">Mov. Disord.</title><idno type="ISSN">0885-3185</idno><idno type="eISSN">1531-8257</idno><imprint><publisher>John Wiley & Sons, Inc.</publisher><pubPlace>New York</pubPlace><date type="published" when="2000-09">2000-09</date><biblScope unit="vol">15</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="826">826</biblScope><biblScope unit="page" to="829">829</biblScope></imprint><idno type="ISSN">0885-3185</idno></series><idno type="istex">D63D3203A1F3B9EF196100C5D16458703990E174</idno><idno type="DOI">10.1002/1531-8257(200009)15:5<826::AID-MDS1010>3.0.CO;2-E</idno><idno type="ArticleID">MDS1010</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Activity</term><term>Age of Onset</term><term>Aged</term><term>Antiparkinson Agents (adverse effects)</term><term>Case-Control Studies</term><term>Complication</term><term>Daily living</term><term>Dementia (epidemiology)</term><term>Dementia (etiology)</term><term>Depression (epidemiology)</term><term>Depression (etiology)</term><term>Diabetes Mellitus (epidemiology)</term><term>Disability</term><term>Drug Tolerance</term><term>Elderly</term><term>Fatigue (epidemiology)</term><term>Fatigue (etiology)</term><term>Female</term><term>Handicap</term><term>Humans</term><term>Levodopa (adverse effects)</term><term>Male</term><term>Management</term><term>Movement Disorders (epidemiology)</term><term>Movement Disorders (etiology)</term><term>Neurologic Examination</term><term>Non‐fluctuators</term><term>Norway (epidemiology)</term><term>Outpatients</term><term>Parkinson Disease (complications)</term><term>Parkinson Disease (epidemiology)</term><term>Parkinson Disease (physiopathology)</term><term>Parkinson Disease (psychology)</term><term>Parkinson disease</term><term>Parkinson's disease</term><term>Prevalence</term><term>Psychometrics</term><term>Psychomotor Performance</term><term>Quality of Life</term><term>Quality of life</term><term>Questionnaires</term><term>Severity of Illness Index</term><term>Sleep Disorders (epidemiology)</term><term>Sleep Disorders (etiology)</term></keywords><keywords scheme="MESH" type="chemical" qualifier="adverse effects" xml:lang="en"><term>Antiparkinson Agents</term><term>Levodopa</term></keywords><keywords scheme="MESH" type="geographic" qualifier="epidemiology" xml:lang="en"><term>Norway</term></keywords><keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Dementia</term><term>Depression</term><term>Diabetes Mellitus</term><term>Fatigue</term><term>Movement Disorders</term><term>Parkinson Disease</term><term>Sleep Disorders</term></keywords><keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Dementia</term><term>Depression</term><term>Fatigue</term><term>Movement Disorders</term><term>Sleep Disorders</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" qualifier="psychology" xml:lang="en"><term>Parkinson Disease</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Age of Onset</term><term>Aged</term><term>Case-Control Studies</term><term>Drug Tolerance</term><term>Female</term><term>Humans</term><term>Male</term><term>Neurologic Examination</term><term>Outpatients</term><term>Prevalence</term><term>Psychomotor Performance</term><term>Quality of Life</term><term>Questionnaires</term><term>Severity of Illness Index</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Activité</term><term>Complication</term><term>Fluctuation motrice</term><term>Handicap</term><term>Incapacité</term><term>Parkinson maladie</term><term>Personne âgée</term><term>Prévalence</term><term>Psychométrie</term><term>Qualité vie</term><term>Vie quotidienne</term></keywords><keywords scheme="Wicri" type="geographic" xml:lang="fr"><term>Norvège</term></keywords><keywords scheme="Wicri" type="topic" xml:lang="fr"><term>Gestion</term><term>Personne âgée</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">OBJECTIVE: To investigate the frequency of non‐fluctuators in a community‐based prevalence study of Parkinson's disease (PD) and to describe disability, non‐motor problems, and health‐related quality of life in patients with PD with and without motor fluctuations, and compare the findings to those of two control groups. METHODS: The study involved 245 patients with PD who were participating in a prevalence study and two control groups (100 healthy elderly individuals and 100 patients with diabetes mellitus [DM]). Data were obtained through neurologic examination and a semistructured interview, and by the use of several questionnaires. RESULTS: In this group of unselected patients with PD, 78% did not experience motor fluctuations. Mean duration of treatment with levodopa was 6.3 years. Patients with motor fluctuations had a lower age at onset of disease, longer duration of disease, and a higher daily levodopa dose than patients without fluctuations. Among the non‐fluctuating patients, we found more dementia and a higher age at prevalence day. Disability (assessed by the Unified Parkinson's Disease Rating Scale subscales for activities of daily living and motor function and the Hoehn and Yahr stage) was similar in fluctuators and non‐fluctuators. Depression, sleep disturbances, and fatigue were equally frequent in both patient groups. The occurrence of these difficulties was clearly more frequent among non‐fluctuating patients with PD than among the control subjects. CONCLUSION: Most patients in the general population who have PD do not experience dose‐dependent motor fluctuations. Severity of motor disability and neuropsychiatric manifestations are as important in non‐fluctuators as in fluctuators. Patients without motor fluctuations have more depression, sleep disturbances, fatigue, and a poorer health‐related quality of life than patients with DM and healthy elderly individuals. This also underlines the importance of developing better management and treatment strategies for this group of patients with PD.</div></front></TEI><affiliations><list><country><li>Norvège</li></country></list><tree><country name="Norvège"><noRegion><name sortKey="Larsen, Jan P" sort="Larsen, Jan P" uniqKey="Larsen J" first="Jan P." last="Larsen">Jan P. Larsen</name></noRegion><name sortKey="Karlsen, Karen" sort="Karlsen, Karen" uniqKey="Karlsen K" first="Karen" last="Karlsen">Karen Karlsen</name><name sortKey="Tandberg, Elise" sort="Tandberg, Elise" uniqKey="Tandberg E" first="Elise" last="Tandberg">Elise Tandberg</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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