Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients
Identifieur interne : 000676 ( Main/Corpus ); précédent : 000675; suivant : 000677Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients
Auteurs : Man Auyeung ; T H Tsoi ; Vincent Mok ; C M Cheung ; C N Lee ; R. Li ; E. YeungSource :
- Journal of Neurology, Neurosurgery & Psychiatry [ 0022-3050 ] ; 2012-06.
Abstract
Objective The 10 year outcomes and impact of motor and non-motor features on survival of a cohort of new onset Chinese Parkinson's disease (PD) patients were prospectively studied. Method A cohort of new onset PD patients from 1995 to 2002 was recruited from a regional hospital based movement disorder clinic. Subjects were classified into postural instability gait disorder (PIGD), tremor predominant type or mixed subtypes at presentation. All were evaluated yearly for development of sensory complaints, first significant fall, hallucinations, dementia, postural hypotension, speech disturbances, dysphagia and postural instability persisted during ‘on’ medication state (PIPon). Mortality and predictors of death were determined. Results 171 new onset PD patients were recruited. After a mean follow-up of 11.3±2.6 years, 50 (29%) patients died. The standardised mortality ratio was 1.1 (CI 0.8 to 1.5, p=0.34). 83 (49%) developed dementia, 81 (47%) had psychosis and 103 (60%) had sensory complaints. Postural hypotension was found in 58 (34%) patients, 108 (63%) had PIPon, 101 (59%) had falls, 102 (60%) had dysphagia, 148 (87%) had freezing of gait and 117 (68%) had speech disturbances. 46 (27%) were institutionalised whereas 54 (32%) lived independently. Dementia (HR 5.0, 95% CI 2.1 to 13.0), PIPon (HR 2.8, 95% CI 1.2 to 6.8), older onset (HR 1.05, 1 year increase in age, 95% CI 1.0 to 1.1) and PIGD type (HR 2.1, 95% CI 1.2 to 3.7) were independent predictors of death. Conclusions 10 years into PD, a significant proportion of patients developed dopa resistant motor and non-motor features. Older onset, PIGD type, PIPon and dementia had a negative impact on survival. Standardised mortality ratio was 1.1.
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DOI: 10.1136/jnnp-2011-301590
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title>Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients</title><author><name sortKey="Auyeung, Man" sort="Auyeung, Man" uniqKey="Auyeung M" first="Man" last="Auyeung">Man Auyeung</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: auyema@yahoo.com.hk</mods:affiliation></affiliation></author><author><name sortKey="Tsoi, T H" sort="Tsoi, T H" uniqKey="Tsoi T" first="T H" last="Tsoi">T H Tsoi</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation></author><author><name sortKey="Mok, Vincent" sort="Mok, Vincent" uniqKey="Mok V" first="Vincent" last="Mok">Vincent Mok</name><affiliation><mods:affiliation>Department of Medicine, Prince of Wales Hospital (Chinese University of Hong Kong), Hong Kong, SAR China</mods:affiliation></affiliation></author><author><name sortKey="Cheung, C M" sort="Cheung, C M" uniqKey="Cheung C" first="C M" last="Cheung">C M Cheung</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation></author><author><name sortKey="Lee, C N" sort="Lee, C N" uniqKey="Lee C" first="C N" last="Lee">C N Lee</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation></author><author><name sortKey="Li, R" sort="Li, R" uniqKey="Li R" first="R" last="Li">R. Li</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation></author><author><name sortKey="Yeung, E" sort="Yeung, E" uniqKey="Yeung E" first="E" last="Yeung">E. Yeung</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:8B1060D45796D213E377479125328BACD2244FEA</idno><date when="2012" year="2012">2012</date><idno type="doi">10.1136/jnnp-2011-301590</idno><idno type="url">https://api.istex.fr/document/8B1060D45796D213E377479125328BACD2244FEA/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000676</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients</title><author><name sortKey="Auyeung, Man" sort="Auyeung, Man" uniqKey="Auyeung M" first="Man" last="Auyeung">Man Auyeung</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation><affiliation><mods:affiliation>E-mail: auyema@yahoo.com.hk</mods:affiliation></affiliation></author><author><name sortKey="Tsoi, T H" sort="Tsoi, T H" uniqKey="Tsoi T" first="T H" last="Tsoi">T H Tsoi</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation></author><author><name sortKey="Mok, Vincent" sort="Mok, Vincent" uniqKey="Mok V" first="Vincent" last="Mok">Vincent Mok</name><affiliation><mods:affiliation>Department of Medicine, Prince of Wales Hospital (Chinese University of Hong Kong), Hong Kong, SAR China</mods:affiliation></affiliation></author><author><name sortKey="Cheung, C M" sort="Cheung, C M" uniqKey="Cheung C" first="C M" last="Cheung">C M Cheung</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation></author><author><name sortKey="Lee, C N" sort="Lee, C N" uniqKey="Lee C" first="C N" last="Lee">C N Lee</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation></author><author><name sortKey="Li, R" sort="Li, R" uniqKey="Li R" first="R" last="Li">R. Li</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation></author><author><name sortKey="Yeung, E" sort="Yeung, E" uniqKey="Yeung E" first="E" last="Yeung">E. Yeung</name><affiliation><mods:affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-06">2012-06</date><biblScope unit="volume">83</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="607">607</biblScope></imprint><idno type="ISSN">0022-3050</idno></series><idno type="istex">8B1060D45796D213E377479125328BACD2244FEA</idno><idno type="DOI">10.1136/jnnp-2011-301590</idno><idno type="href">jnnp-83-607.pdf</idno><idno type="ArticleID">jnnp-2011-301590</idno><idno type="PMID">22362919</idno><idno type="local">jnnp;83/6/607</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0022-3050</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">Objective The 10 year outcomes and impact of motor and non-motor features on survival of a cohort of new onset Chinese Parkinson's disease (PD) patients were prospectively studied. Method A cohort of new onset PD patients from 1995 to 2002 was recruited from a regional hospital based movement disorder clinic. Subjects were classified into postural instability gait disorder (PIGD), tremor predominant type or mixed subtypes at presentation. All were evaluated yearly for development of sensory complaints, first significant fall, hallucinations, dementia, postural hypotension, speech disturbances, dysphagia and postural instability persisted during ‘on’ medication state (PIPon). Mortality and predictors of death were determined. Results 171 new onset PD patients were recruited. After a mean follow-up of 11.3±2.6 years, 50 (29%) patients died. The standardised mortality ratio was 1.1 (CI 0.8 to 1.5, p=0.34). 83 (49%) developed dementia, 81 (47%) had psychosis and 103 (60%) had sensory complaints. Postural hypotension was found in 58 (34%) patients, 108 (63%) had PIPon, 101 (59%) had falls, 102 (60%) had dysphagia, 148 (87%) had freezing of gait and 117 (68%) had speech disturbances. 46 (27%) were institutionalised whereas 54 (32%) lived independently. Dementia (HR 5.0, 95% CI 2.1 to 13.0), PIPon (HR 2.8, 95% CI 1.2 to 6.8), older onset (HR 1.05, 1 year increase in age, 95% CI 1.0 to 1.1) and PIGD type (HR 2.1, 95% CI 1.2 to 3.7) were independent predictors of death. Conclusions 10 years into PD, a significant proportion of patients developed dopa resistant motor and non-motor features. Older onset, PIGD type, PIPon and dementia had a negative impact on survival. Standardised mortality ratio was 1.1.</div></front></TEI><istex><corpusName>bmj</corpusName><author><json:item><name>Man Auyeung</name><affiliations><json:string>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</json:string><json:string>E-mail: auyema@yahoo.com.hk</json:string></affiliations></json:item><json:item><name>T H Tsoi</name><affiliations><json:string>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</json:string></affiliations></json:item><json:item><name>Vincent Mok</name><affiliations><json:string>Department of Medicine, Prince of Wales Hospital (Chinese University of Hong Kong), Hong Kong, SAR China</json:string></affiliations></json:item><json:item><name>C M Cheung</name><affiliations><json:string>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</json:string></affiliations></json:item><json:item><name>C N Lee</name><affiliations><json:string>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</json:string></affiliations></json:item><json:item><name>R Li</name><affiliations><json:string>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</json:string></affiliations></json:item><json:item><name>E Yeung</name><affiliations><json:string>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>Movement disorders</value></json:item></subject><language><json:string>eng</json:string></language><abstract>Objective The 10 year outcomes and impact of motor and non-motor features on survival of a cohort of new onset Chinese Parkinson's disease (PD) patients were prospectively studied. Method A cohort of new onset PD patients from 1995 to 2002 was recruited from a regional hospital based movement disorder clinic. Subjects were classified into postural instability gait disorder (PIGD), tremor predominant type or mixed subtypes at presentation. All were evaluated yearly for development of sensory complaints, first significant fall, hallucinations, dementia, postural hypotension, speech disturbances, dysphagia and postural instability persisted during ‘on’ medication state (PIPon). Mortality and predictors of death were determined. Results 171 new onset PD patients were recruited. After a mean follow-up of 11.3±2.6 years, 50 (29%) patients died. The standardised mortality ratio was 1.1 (CI 0.8 to 1.5, p=0.34). 83 (49%) developed dementia, 81 (47%) had psychosis and 103 (60%) had sensory complaints. Postural hypotension was found in 58 (34%) patients, 108 (63%) had PIPon, 101 (59%) had falls, 102 (60%) had dysphagia, 148 (87%) had freezing of gait and 117 (68%) had speech disturbances. 46 (27%) were institutionalised whereas 54 (32%) lived independently. Dementia (HR 5.0, 95% CI 2.1 to 13.0), PIPon (HR 2.8, 95% CI 1.2 to 6.8), older onset (HR 1.05, 1 year increase in age, 95% CI 1.0 to 1.1) and PIGD type (HR 2.1, 95% CI 1.2 to 3.7) were independent predictors of death. Conclusions 10 years into PD, a significant proportion of patients developed dopa resistant motor and non-motor features. Older onset, PIGD type, PIPon and dementia had a negative impact on survival. Standardised mortality ratio was 1.1.</abstract><qualityIndicators><score>7.246</score><pdfVersion>1.4</pdfVersion><pdfPageSize>595.276 x 793.701 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>1</keywordCount><abstractCharCount>1723</abstractCharCount><pdfWordCount>3746</pdfWordCount><pdfCharCount>24549</pdfCharCount><pdfPageCount>5</pdfPageCount><abstractWordCount>264</abstractWordCount></qualityIndicators><title>Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients</title><pmid><json:string>22362919</json:string></pmid><genre><json:string>research-article</json:string></genre><host><volume>83</volume><pages><first>607</first></pages><issn><json:string>0022-3050</json:string></issn><issue>6</issue><genre></genre><language><json:string>unknown</json:string></language><eissn><json:string>1468-330X</json:string></eissn><title>Journal of Neurology, Neurosurgery & Psychiatry</title></host><publicationDate>2012</publicationDate><copyrightDate>2012</copyrightDate><doi><json:string>10.1136/jnnp-2011-301590</json:string></doi><id>8B1060D45796D213E377479125328BACD2244FEA</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/8B1060D45796D213E377479125328BACD2244FEA/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/8B1060D45796D213E377479125328BACD2244FEA/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/8B1060D45796D213E377479125328BACD2244FEA/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a">Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>BMJ Publishing Group Ltd</publisher><availability><p>BMJ</p></availability><date>2012-02-22</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a">Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients</title><author corresp="yes"><persName><forename type="first">Man</forename><surname>Auyeung</surname></persName><email>auyema@yahoo.com.hk</email><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation></author><author><persName><forename type="first">T H</forename><surname>Tsoi</surname></persName><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation></author><author><persName><forename type="first">Vincent</forename><surname>Mok</surname></persName><affiliation>Department of Medicine, Prince of Wales Hospital (Chinese University of Hong Kong), Hong Kong, SAR China</affiliation></author><author><persName><forename type="first">C M</forename><surname>Cheung</surname></persName><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation></author><author><persName><forename type="first">C N</forename><surname>Lee</surname></persName><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation></author><author><persName><forename type="first">R</forename><surname>Li</surname></persName><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation></author><author><persName><forename type="first">E</forename><surname>Yeung</surname></persName><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation></author></analytic><monogr><title level="j">Journal of Neurology, Neurosurgery & Psychiatry</title><title level="j" type="abbrev">J Neurol Neurosurg Psychiatry</title><idno type="pISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><publisher>BMJ Publishing Group Ltd</publisher><date type="published" when="2012-06"></date><biblScope unit="volume">83</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="607">607</biblScope></imprint></monogr><idno type="istex">8B1060D45796D213E377479125328BACD2244FEA</idno><idno type="DOI">10.1136/jnnp-2011-301590</idno><idno type="href">jnnp-83-607.pdf</idno><idno type="ArticleID">jnnp-2011-301590</idno><idno type="PMID">22362919</idno><idno type="local">jnnp;83/6/607</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2012-02-22</date></creation><langUsage><language ident="en">en</language></langUsage><abstract><p>Objective The 10 year outcomes and impact of motor and non-motor features on survival of a cohort of new onset Chinese Parkinson's disease (PD) patients were prospectively studied. Method A cohort of new onset PD patients from 1995 to 2002 was recruited from a regional hospital based movement disorder clinic. Subjects were classified into postural instability gait disorder (PIGD), tremor predominant type or mixed subtypes at presentation. All were evaluated yearly for development of sensory complaints, first significant fall, hallucinations, dementia, postural hypotension, speech disturbances, dysphagia and postural instability persisted during ‘on’ medication state (PIPon). Mortality and predictors of death were determined. Results 171 new onset PD patients were recruited. After a mean follow-up of 11.3±2.6 years, 50 (29%) patients died. The standardised mortality ratio was 1.1 (CI 0.8 to 1.5, p=0.34). 83 (49%) developed dementia, 81 (47%) had psychosis and 103 (60%) had sensory complaints. Postural hypotension was found in 58 (34%) patients, 108 (63%) had PIPon, 101 (59%) had falls, 102 (60%) had dysphagia, 148 (87%) had freezing of gait and 117 (68%) had speech disturbances. 46 (27%) were institutionalised whereas 54 (32%) lived independently. Dementia (HR 5.0, 95% CI 2.1 to 13.0), PIPon (HR 2.8, 95% CI 1.2 to 6.8), older onset (HR 1.05, 1 year increase in age, 95% CI 1.0 to 1.1) and PIGD type (HR 2.1, 95% CI 1.2 to 3.7) were independent predictors of death. Conclusions 10 years into PD, a significant proportion of patients developed dopa resistant motor and non-motor features. Older onset, PIGD type, PIPon and dementia had a negative impact on survival. Standardised mortality ratio was 1.1.</p></abstract></profileDesc><revisionDesc><change when="2012-02-22">Created</change><change when="2012-06">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/8B1060D45796D213E377479125328BACD2244FEA/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="corpus bmj" wicri:toSee="no header"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="no"</istex:xmlDeclaration><istex:docType PUBLIC="-//NLM//DTD Journal Archiving and Interchange DTD v2.3 20070202//EN" URI="archivearticle.dtd" name="istex:docType"></istex:docType><istex:document><article article-type="research-article"><front><journal-meta><journal-id journal-id-type="hwp">jnnp</journal-id><journal-id journal-id-type="nlm-ta">J Neurol Neurosurg Psychiatry</journal-id><journal-id journal-id-type="publisher-id">jnnp</journal-id><journal-title>Journal of Neurology, Neurosurgery & Psychiatry</journal-title><abbrev-journal-title abbrev-type="publisher">J Neurol Neurosurg Psychiatry</abbrev-journal-title><abbrev-journal-title>J Neurol Neurosurg Psychiatry</abbrev-journal-title><issn pub-type="ppub">0022-3050</issn><issn pub-type="epub">1468-330X</issn><publisher><publisher-name>BMJ Publishing Group Ltd</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="publisher-id">jnnp-2011-301590</article-id><article-id pub-id-type="doi">10.1136/jnnp-2011-301590</article-id><article-id pub-id-type="other">jnnp;83/6/607</article-id><article-id pub-id-type="other">jnnp;jnnp-2011-301590</article-id><article-id pub-id-type="pmid">22362919</article-id><article-id pub-id-type="other">607</article-id><article-id pub-id-type="other">jnnp-2011-301590</article-id><article-categories><subj-group subj-group-type="heading"><subject>Movement disorders</subject></subj-group><series-title>Research paper</series-title></article-categories><title-group><article-title>Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Auyeung</surname><given-names>Man</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Tsoi</surname><given-names>T H</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Mok</surname><given-names>Vincent</given-names></name><xref ref-type="aff" rid="aff2">2</xref></contrib><contrib contrib-type="author"><name><surname>Cheung</surname><given-names>C M</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Lee</surname><given-names>C N</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Li</surname><given-names>R</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib><contrib contrib-type="author"><name><surname>Yeung</surname><given-names>E</given-names></name><xref ref-type="aff" rid="aff1">1</xref></contrib></contrib-group><aff id="aff1"><label>1</label>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</aff><aff id="aff2"><label>2</label>Department of Medicine, Prince of Wales Hospital (Chinese University of Hong Kong), Hong Kong, SAR China</aff><author-notes><corresp><label>Correspondence to</label> Dr M Auyeung, Department of Medicine, Pamela Youde Nethersole Eastern Hospital, 3rd Lok Man Road, Chai Wan, Hong Kong, SAR China; <email>auyema@yahoo.com.hk</email></corresp></author-notes><pub-date pub-type="epub-original"><day>22</day><month>2</month><year>2012</year></pub-date><pub-date pub-type="ppub"><month>6</month><year>2012</year></pub-date><pub-date pub-type="epub"><day>22</day><month>2</month><year>2012</year></pub-date><volume>83</volume><volume-id pub-id-type="other">83</volume-id><volume-id pub-id-type="other">83</volume-id><issue>6</issue><issue-id pub-id-type="other">jnnp;83/6</issue-id><issue-id pub-id-type="other">6</issue-id><issue-id pub-id-type="other">83/6</issue-id><fpage>607</fpage><history><date date-type="received"><day>7</day><month>10</month><year>2011</year></date><date date-type="rev-recd"><day>24</day><month>1</month><year>2012</year></date><date date-type="accepted"><day>25</day><month>1</month><year>2012</year></date></history><permissions><copyright-statement>© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</copyright-statement><copyright-year>2012</copyright-year></permissions><self-uri content-type="pdf" xlink:role="full-text" xlink:href="jnnp-83-607.pdf"></self-uri><abstract><sec><title>Objective</title><p>The 10 year outcomes and impact of motor and non-motor features on survival of a cohort of new onset Chinese Parkinson's disease (PD) patients were prospectively studied.</p></sec><sec><title>Method</title><p>A cohort of new onset PD patients from 1995 to 2002 was recruited from a regional hospital based movement disorder clinic. Subjects were classified into postural instability gait disorder (PIGD), tremor predominant type or mixed subtypes at presentation. All were evaluated yearly for development of sensory complaints, first significant fall, hallucinations, dementia, postural hypotension, speech disturbances, dysphagia and postural instability persisted during ‘on’ medication state (PIPon). Mortality and predictors of death were determined.</p></sec><sec><title>Results</title><p>171 new onset PD patients were recruited. After a mean follow-up of 11.3±2.6 years, 50 (29%) patients died. The standardised mortality ratio was 1.1 (CI 0.8 to 1.5, p=0.34). 83 (49%) developed dementia, 81 (47%) had psychosis and 103 (60%) had sensory complaints. Postural hypotension was found in 58 (34%) patients, 108 (63%) had PIPon, 101 (59%) had falls, 102 (60%) had dysphagia, 148 (87%) had freezing of gait and 117 (68%) had speech disturbances. 46 (27%) were institutionalised whereas 54 (32%) lived independently. Dementia (HR 5.0, 95% CI 2.1 to 13.0), PIPon (HR 2.8, 95% CI 1.2 to 6.8), older onset (HR 1.05, 1 year increase in age, 95% CI 1.0 to 1.1) and PIGD type (HR 2.1, 95% CI 1.2 to 3.7) were independent predictors of death.</p></sec><sec><title>Conclusions</title><p>10 years into PD, a significant proportion of patients developed dopa resistant motor and non-motor features. Older onset, PIGD type, PIPon and dementia had a negative impact on survival. Standardised mortality ratio was 1.1.</p></sec></abstract></article-meta></front></article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo><partName>Research paper</partName><title>Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients</title></titleInfo><titleInfo type="alternative" contentType="CDATA"><partName>Research paper</partName><title>Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients</title></titleInfo><name type="personal" displayLabel="corresp"><namePart type="given">Man</namePart><namePart type="family">Auyeung</namePart><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation><affiliation>E-mail: auyema@yahoo.com.hk</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">T H</namePart><namePart type="family">Tsoi</namePart><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Vincent</namePart><namePart type="family">Mok</namePart><affiliation>Department of Medicine, Prince of Wales Hospital (Chinese University of Hong Kong), Hong Kong, SAR China</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C M</namePart><namePart type="family">Cheung</namePart><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">C N</namePart><namePart type="family">Lee</namePart><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">R</namePart><namePart type="family">Li</namePart><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">E</namePart><namePart type="family">Yeung</namePart><affiliation>Department of Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="research-article"></genre><originInfo><publisher>BMJ Publishing Group Ltd</publisher><dateIssued encoding="w3cdtf">2012-06</dateIssued><dateCreated encoding="w3cdtf">2012-02-22</dateCreated><copyrightDate encoding="w3cdtf">2012</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract>Objective The 10 year outcomes and impact of motor and non-motor features on survival of a cohort of new onset Chinese Parkinson's disease (PD) patients were prospectively studied. Method A cohort of new onset PD patients from 1995 to 2002 was recruited from a regional hospital based movement disorder clinic. Subjects were classified into postural instability gait disorder (PIGD), tremor predominant type or mixed subtypes at presentation. All were evaluated yearly for development of sensory complaints, first significant fall, hallucinations, dementia, postural hypotension, speech disturbances, dysphagia and postural instability persisted during ‘on’ medication state (PIPon). Mortality and predictors of death were determined. Results 171 new onset PD patients were recruited. After a mean follow-up of 11.3±2.6 years, 50 (29%) patients died. The standardised mortality ratio was 1.1 (CI 0.8 to 1.5, p=0.34). 83 (49%) developed dementia, 81 (47%) had psychosis and 103 (60%) had sensory complaints. Postural hypotension was found in 58 (34%) patients, 108 (63%) had PIPon, 101 (59%) had falls, 102 (60%) had dysphagia, 148 (87%) had freezing of gait and 117 (68%) had speech disturbances. 46 (27%) were institutionalised whereas 54 (32%) lived independently. Dementia (HR 5.0, 95% CI 2.1 to 13.0), PIPon (HR 2.8, 95% CI 1.2 to 6.8), older onset (HR 1.05, 1 year increase in age, 95% CI 1.0 to 1.1) and PIGD type (HR 2.1, 95% CI 1.2 to 3.7) were independent predictors of death. Conclusions 10 years into PD, a significant proportion of patients developed dopa resistant motor and non-motor features. Older onset, PIGD type, PIPon and dementia had a negative impact on survival. Standardised mortality ratio was 1.1.</abstract><relatedItem type="host"><titleInfo><title>Journal of Neurology, Neurosurgery & Psychiatry</title></titleInfo><titleInfo type="abbreviated"><title>J Neurol Neurosurg Psychiatry</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0022-3050</identifier><identifier type="eISSN">1468-330X</identifier><identifier type="PublisherID">jnnp</identifier><identifier type="PublisherID-hwp">jnnp</identifier><identifier type="PublisherID-nlm-ta">J Neurol Neurosurg Psychiatry</identifier><part><date>2012</date><detail type="volume"><caption>vol.</caption><number>83</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>607</start></extent></part></relatedItem><identifier type="istex">8B1060D45796D213E377479125328BACD2244FEA</identifier><identifier type="DOI">10.1136/jnnp-2011-301590</identifier><identifier type="href">jnnp-83-607.pdf</identifier><identifier type="ArticleID">jnnp-2011-301590</identifier><identifier type="PMID">22362919</identifier><identifier type="local">jnnp;83/6/607</identifier><accessCondition type="use and reproduction" contentType="copyright">© 2012, Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.</accessCondition><recordInfo><recordContentSource>BMJ</recordContentSource></recordInfo></mods></metadata><annexes><json:item><original>true</original><mimetype>image/jpeg</mimetype><extension>jpeg</extension><uri>https://api.istex.fr/document/8B1060D45796D213E377479125328BACD2244FEA/annexes/jpeg</uri></json:item></annexes><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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