scholarly journals The estimated life expectancy in a community cohort of Parkinson's disease patients with and without dementia, compared with the UK population

2010 ◽  
Vol 81 (10) ◽  
pp. 1093-1098 ◽  
Author(s):  
P. Hobson ◽  
J. Meara ◽  
L. Ishihara-Paul
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Life Expectancy ◽  
The Uk

Dopamine agonists for parkinson’s disease

1991 ◽  
Vol 29 (2) ◽  
pp. 7-8
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Side Effects ◽  
Therapeutic Efficacy ◽  
Dopamine Agonists ◽  
Dopa Decarboxylase ◽  
Decarboxylase Inhibitor ◽  
Duration Of Action ◽  
Motor Disability ◽  
The Uk

Bromocriptine, lysuride (formerly lisuride, Revanil – Roche) and pergolide (not yet marketed in the UK) are dopamine agonists developed for use in the treatment of patients with Parkinson’s disease. Combination of a dopamine agonist with levodopa plus a dopa-decarboxylase inhibitor (‘co-dieldopa’)* may have advantages at all stages of the disease. The aim of combined co-dieldopa + agonist treatment is to limit some of the problems with prolonged co-dieldopa use alone; especially fluctuations in motor disability.1 It is still not clear how the three agonists compare with each other for therapeutic efficacy, duration of action, and side effects, nor how they are best combined with co-dieldopa.

scholarly journals Dietary intake of folate, vitamin B6, vitamin B12 and riboflavin and risk of Parkinson's disease: a case–control study in Japan

2010 ◽  
Vol 104 (5) ◽  
pp. 757-764 ◽  
Author(s):  
Kentaro Murakami ◽  
Yoshihiro Miyake ◽  
Satoshi Sasaki ◽  
Keiko Tanaka ◽  
Wakaba Fukushima ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Dietary Intake ◽  
Case Control Study ◽  
Case Control ◽  
B Vitamins ◽  
Vitamin B ◽  
Increased Risk ◽  
The Uk ◽  
Control Study

Increased homocysteine levels might accelerate dopaminergic cell death in Parkinson's disease (PD) through neurotoxic effects; thus, increasing intake of B vitamins involved in the regulation of homocysteine metabolism might decrease the risk of PD through decreasing plasma homocysteine. However, epidemiological evidence for the association of dietary B vitamins with PD is sparse, particularly in non-Western populations. We conducted a hospital-based case–control study in Japan to examine associations between dietary intake of folate, vitamin B6, vitamin B12 and riboflavin and the risk of PD. Patients with PD diagnosed using the UK PD Society Brain Bank criteria (n 249) and controls without neurodegenerative diseases (n 368) were recruited. Dietary intake during the preceding month was assessed at the time of study recruitment using a validated, self-administered, semi-quantitative, comprehensive diet history questionnaire. After adjustment for potential dietary and non-dietary confounding factors, intake of folate, vitamin B12 and riboflavin was not associated with the risk of PD (P for trend = 0·87, 0·70 and 0·11, respectively). However, low intake of vitamin B6 was associated with an increased risk of PD, independent of potential dietary and non-dietary confounders. Multivariate OR (95 % CI) for PD in the first, second, third and fourth quartiles of vitamin B6 were 1 (reference), 0·56 (0·33, 0·94), 0·69 (0·38, 1·25) and 0·48 (0·23, 0·99), respectively (P for trend = 0·10). In conclusion, in the present case–control study in Japan, low intake of vitamin B6, but not of folate, vitamin B12 or riboflavin, was independently associated with an increased risk of PD.

THUR 121 Identifying participants with parkinson’s disease in uk biobank

2018 ◽  
Vol 89 (10) ◽  
pp. A13.2-A13
Author(s):  
Bush Kathryn ◽  
Rannikmae Kristiina ◽  
Schnier Christian ◽  
Wilkinson Timothy ◽  
Nolan John ◽  
...  
Keyword(s):  
Primary Care ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Secondary Care ◽  
Large Population ◽  
Free Text ◽  
Uk Biobank ◽  
Predictive Values ◽  
Diagnostic Codes ◽  
The Uk

BackgroundLinkage to routinely collected NHS data from primary, secondary care and death certificates enables identification of participants with Parkinson’s Disease (PD) within the UK Biobank cohort of 5 00 000 adults. Validation of the accuracy of this data is required prior to their use in research studies.MethodIn this validation study participants (n=125) with a code indicating PD were identified from a sample of 17 000 participants in the cohort. Diagnoses were validated by expert adjudicators, based on free text electronic medical records. Positive predictive values (PPV,% of cases identified that are true cases) were calculated.ResultsPrimary care diagnostic codes identified 93% of PD cases, with a PPV of 95%. Combined secondary care and death data identified 42% of PD cases with a PPV of 84%.Combining diagnostic and medication codes identified more participants, but did not increase the PPV.ConclusionsThis study suggests that linkage to routinely collected healthcare data is a reliable method for identifying participants with PD in the UK Biobank cohort.Primary care diagnostic codes identified the highest proportion of participants and had the highest PPV, demonstrating the value of using primary care data to identify cases of disease in large population based cohort studies.

Physiotherapy for people with Parkinson's disease in the UK: an exploration of practice

2004 ◽  
Vol 11 (4) ◽  
pp. 160-167 ◽  
Author(s):  
Ann Ashburn ◽  
Diana Jones ◽  
Rowena Plant ◽  
Brenda Lövgreen ◽  
Elizabeth Kinnear ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
The Uk

scholarly journals Development of ethical governance framework for an mHealth platform for the management of Parkison’s

2019 ◽  
Vol 29 (Supplement_4) ◽  
Author(s):  
L Timotijevic ◽  
M Peacock ◽  
C Hodgkins ◽  
B M Egan
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Qualitative Interviews ◽  
Rapid Expansion ◽  
Policy Makers ◽  
Governance Framework ◽  
Risks And Benefits ◽  
Effective System ◽  
The Uk ◽  
Ethical Governance

Abstract Background The ubiquity of mobile devices promises to address the need for continuous management of chronic conditions at lower costs. Its rapid expansion, particularly in public health, is currently largely consumer-driven and lacking in acceptable frameworks for its wider adoption into the healthcare systems. The aim of this study is to identify the key parameters to consider in developing a governance framework for a Parkinson’s Disease Management MHealth platform. The Parkinson’s Disease Manager (PDM) system was developed to gather symptom information from patients with PD via wearable devices and a specially designed app and stored securely in a cloud, for use by clinicians, health researchers and policy makers. Methodology Twelve stakeholders were interviewed in the UK including clinicians, data managers, the public. First, the participants’ existing views about sharing personal and then specifically health data online were explored. Secondly, participants were introduced to PDM via a diagram and encouraged to explore the risks and benefits of the system with a minimum of guidance. Finally, they were asked what risks they thought might be posed by a series of specific scenarios presented through vignettes and how such issues might be addressed. Results Thematic analysis identified eight emerging themes which clustered around two overarching categories: 1. The key challenges of the system identified included: Establishing appropriate governance; Protecting the data; Ensuring sustainability; Building trust; 2. The proposed solutions included: Ethically informed governance; Embedded data custodians; Sustainable funding and engagement; Trust through transparency. Conclusions The patient’s heuristic assessment of risks and benefits is mediated by trust, which can be initially gained by association with individuals and organisations already deemed trustworthy and then consolidated and sustained through transparency and delivering on promises. Key messages The effective system design, must ensure that standards of transparency, data protection and informed consent are upheld if the coming eHealth revolution is ever to realise its true potential. The use of diagrams and vignettes to support qualitative interviews helped elucidate the importance of balancing protection, utility and sustainability to build and maintain trust.

MORTALITY IN PARKINSON'S DISEASE AND ATYPICAL PARKINSONIAN DISORDERS

2015 ◽  
Vol 86 (11) ◽  
pp. e4.88-e4
Author(s):  
Angus Macleod ◽  
Carl Counsell
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Life Expectancy ◽  
Median Survival ◽  
Lewy Body Dementia ◽  
Mortality Data ◽  
Kaplan Meier ◽  
Central Register ◽  
Population Mortality ◽  
Incident Cohort

BackgroundWe evaluated the mortality associated with Parkinson's disease (PD), Lewy body dementia (LBD), progressive supranuclear palsy (PSP), multiple system atrophy (MSA), and vascular parkinsonism (VP) using a community-based incident cohort.MethodsAll incident parkinsonism cases identified over 4.5 years (2002-4, 2006-9) were tagged to the NHS central register for regular death notifications. Kaplan-Meier survival probabilities were plotted. Standardised mortality ratios (SMRs) and life expectancy, adjusted for age, sex and calendar year, were calculated using regional mortality data.ResultsUntil June 2014, 90 deaths occurred in 198 PD patients, and 107 deaths in 117 patients with other syndromes. Median survival in PD, LBD, PSP, MSA, and VP was 7.8 (6.7–9.4), 3.3 (2.3–4.1), 2.6 (1.1–3.8), 5.1 (1.3–NA), 2.1 (1.5–3.4) years, respectively. SMRs were 1.5 (1.2–1.9), 4.2 (3.0–5.9), 3.8 (2.6–5.5), 1.8 (0.9–3.4), 4.2 (3.0–6.0) respectively. In PD, median survival was lower than life expectancy, but more so in under 65s.ConclusionsMortality in PD was increased by 50% over expected population mortality. Younger patients have proportionally more to lose. Survival was much poorer in other syndromes.

scholarly journals Clinical diagnosis of Lewy body dementia

BJPsych Open ◽  
2020 ◽  
Vol 6 (4) ◽  
Author(s):  
Ajenthan Surendranathan ◽  
Joseph P. M. Kane ◽  
Allison Bentley ◽  
Sally A. H. Barker ◽  
John-Paul Taylor ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Dopamine Transporter ◽  
Lewy Body ◽  
Lewy Bodies ◽  
Lewy Body Dementia ◽  
Final Diagnosis ◽  
Dopamine Transporter Imaging ◽  
The Uk

Background Lewy body dementia, consisting of both dementia with Lewy bodies (DLB) and Parkinson's disease dementia (PDD), is considerably under-recognised clinically compared with its frequency in autopsy series. Aims This study investigated the clinical diagnostic pathways of patients with Lewy body dementia to assess if difficulties in diagnosis may be contributing to these differences. Method We reviewed the medical notes of 74 people with DLB and 72 with non-DLB dementia matched for age, gender and cognitive performance, together with 38 people with PDD and 35 with Parkinson's disease, matched for age and gender, from two geographically distinct UK regions. Results The cases of individuals with DLB took longer to reach a final diagnosis (1.2 v. 0.6 years, P = 0.017), underwent more scans (1.7 v. 1.2, P = 0.002) and had more alternative prior diagnoses (0.8 v. 0.4, P = 0.002), than the cases of those with non-DLB dementia. Individuals diagnosed in one region of the UK had significantly more core features (2.1 v. 1.5, P = 0.007) than those in the other region, and were less likely to have dopamine transporter imaging (P < 0.001). For patients with PDD, more than 1.4 years prior to receiving a dementia diagnosis: 46% (12 of 26) had documented impaired activities of daily living because of cognitive impairment, 57% (16 of 28) had cognitive impairment in multiple domains, with 38% (6 of 16) having both, and 39% (9 of 23) already receiving anti-dementia drugs. Conclusions Our results show the pathway to diagnosis of DLB is longer and more complex than for non-DLB dementia. There were also marked differences between regions in the thresholds clinicians adopt for diagnosing DLB and also in the use of dopamine transporter imaging. For PDD, a diagnosis of dementia was delayed well beyond symptom onset and even treatment.

Parkinson's disease and the COVID-19 pandemic: responding to patient need with nurse-led telemedicine

2020 ◽  
Vol 16 (3) ◽  
pp. 131-133 ◽  
Author(s):  
Sue Thomas ◽  
Francesca Mancini ◽  
Louise Ebenezer ◽  
Jane Price ◽  
Tania Carta ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Patient Engagement ◽  
Face To Face ◽  
The Uk ◽  
Alternative Solutions ◽  
Treatment And Diagnosis

With the COVID-19 pandemic limiting face-to-face interaction, the drive for innovation and the need to develop alternative solutions to patient engagement, treatment and diagnosis has been suddenly accelerated. Sue Thomas and national and international colleagues outline a novel technological initiative launched in Italy to cope with the pressures of the pandemic, providing inspiration for similar future projects in the UK

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