Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients
Identifieur interne : 000026 ( Main/Exploration ); précédent : 000025; suivant : 000027Ten year survival and outcomes in a prospective cohort of new onset Chinese Parkinson's disease patients
Auteurs : Man Auyeung [Hong Kong] ; T H Tsoi [Hong Kong] ; Vincent Mok ; C M Cheung [Hong Kong] ; C N Lee [Hong Kong] ; R. Li [Hong Kong] ; E. Yeung [Hong Kong]Source :
- 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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Yeung</name><affiliation wicri:level="1"><country xml:lang="fr">Hong Kong</country><wicri:regionArea>Department of Medicine, Pamela Youde Nethersole Eastern Hospital</wicri:regionArea><wicri:noRegion>Pamela Youde Nethersole Eastern Hospital</wicri:noRegion></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><affiliations><list><country><li>Hong Kong</li></country></list><tree><noCountry><name sortKey="Mok, Vincent" sort="Mok, Vincent" uniqKey="Mok V" first="Vincent" last="Mok">Vincent Mok</name></noCountry><country name="Hong Kong"><noRegion><name sortKey="Auyeung, Man" sort="Auyeung, Man" uniqKey="Auyeung M" first="Man" last="Auyeung">Man Auyeung</name></noRegion><name sortKey="Auyeung, Man" sort="Auyeung, Man" uniqKey="Auyeung M" first="Man" last="Auyeung">Man Auyeung</name><name sortKey="Cheung, C M" sort="Cheung, C M" uniqKey="Cheung C" first="C M" last="Cheung">C M Cheung</name><name sortKey="Lee, C N" sort="Lee, C N" uniqKey="Lee C" first="C N" last="Lee">C N Lee</name><name sortKey="Li, R" sort="Li, R" uniqKey="Li R" first="R" last="Li">R. Li</name><name sortKey="Tsoi, T H" sort="Tsoi, T H" uniqKey="Tsoi T" first="T H" last="Tsoi">T H Tsoi</name><name sortKey="Yeung, E" sort="Yeung, E" uniqKey="Yeung E" first="E" last="Yeung">E. Yeung</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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