Time to modification of antiparkinson therapy in a group of patients from Colombia v1

2021 ◽  
Author(s):  
Jorge Machado Alba
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Drug Therapy ◽  
Cox Regression ◽  
Initial Therapy ◽  
Pharmacological Therapy ◽  
Active Principle ◽  
Related Factors ◽  
Therapy Modification ◽  
Mean Time

Aims:To determine the time elapsed between the start of treatment with antiparkinson agents and the modification of the pharmacological therapy, and to establish its related factors, in a group of patients with Parkinson's disease from Colombia. Methods: Retrospective cohort study that collected information about the treatment of patients with Parkinson's disease who started drug therapy between June-2011 and December-2013; a 5-year follow-up was performed. Survival analyses for time to therapy modification were generated, and factors related to these changes were determined using Cox regression models. Results: A total of 3,224 patients (51.8% men) with a mean age of 73.1 ± 13.5 years started treatment with antiparkinson agents. After 5 years, 2,046 patients (63.5%) had modifications in drug therapy, in a mean time of 36.4 months (95% CI: 35.7-37.1). A total of 1,216 patients (37.8%) required the addition of another active principle, while 830 (25.7%) had a switch to another drug. In the multivariate analysis, male gender, age over 65 years, and the start of amantadine were identified as factors that increased the likelihood of therapy modification. The use of bromocriptine, biperiden, and monotherapy as an initial treatment were associated with a reduction in this likelihood. Conclusions: After 5 years of treatment, 63.5% of the patients with Parkinson's disease required modifications of their therapy, with a mean time of 3 years. Male sex, age over 65 years, and receiving initial therapy with amantadine affected the likelihood of switching therapy in these patients in Colombia.

scholarly journals The impact of depression on survival of Parkinson's disease patients: a five-year study

2013 ◽  
Vol 62 (1) ◽  
pp. 8-12 ◽  
Author(s):  
Cláudia Débora Silberman ◽  
Cláudia Soares Rodrigues ◽  
Eliasz Engelhardt ◽  
Jerson Laks
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cox Regression ◽  
Rank Test ◽  
First Year ◽  
Kaplan Meier ◽  
Significant Difference ◽  
The Impact ◽  
Mean Time

OBJECTIVE: The aim of this study is to evaluate the survival rate in a cohort of Parkinson's disease patients with and without depression. METHODS: A total of 53 Parkinson's disease subjects were followed up from 2003-2008 and 21 were diagnosed as depressed. Mean time of follow up was 3.8 (SD 95% = 1.5) years for all the sample and there was no significant difference in mean time of follow up between depressed and nondepressed Parkinson's disease patients. Survival curves rates were fitted using the Kaplan-Meier method. In order to compare survival probabilities according to the selected covariables the Log-Rank test was used. Multivariate analysis with Cox regression was performed aiming at estimating the effect of predictive covariables on the survival. RESULTS: The cumulative global survival of this sample was 83% with nine deaths at the end of the study - five in the depressed and four in the nondepressed group, and 55.6% died in the first year of observation, and none died at the fourth and fifth year of follow up. CONCLUSION: Our finding point toward incremental death risk in depressed Parkinson's disease patients.

Falls Predict Acute Hospitalization in Parkinson’s Disease

2021 ◽  
pp. 1-20
Author(s):  
Diego Santos García ◽  
Teresa de Deus Fonticoba ◽  
Carlos Cores ◽  
Ester Suárez Castro ◽  
Jorge Hernández Vara ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cox Regression ◽  
Independent Predictor ◽  
Hazard Ratio ◽  
Acute Hospitalization ◽  
Baseline Visit ◽  
Kaplan Meier ◽  
Non Motor Symptoms

Background: There is a need for identifying risk factors for hospitalization in Parkinson’s disease (PD) and also interventions to reduce acute hospital admission. Objective: To analyze the frequency, causes, and predictors of acute hospitalization (AH) in PD patients from a Spanish cohort. Methods: PD patients recruited from 35 centers of Spain from the COPPADIS-2015 (COhort of Patients with PArkinson’s DIsease in Spain, 2015) cohort from January 2016 to November 2017, were included in the study. In order to identify predictors of AH, Kaplan-Meier estimates of factors considered as potential predictors were obtained and Cox regression performed on time to hospital encounter 1-year after the baseline visit. Results: Thirty-five out of 605 (5.8%) PD patients (62.5±8.9 years old; 59.8% males) presented an AH during the 1-year follow-up after the baseline visit. Traumatic falls represented the most frequent cause of admission, being 23.7% of all acute hospitalizations. To suffer from motor fluctuations (HR [hazard ratio] 2.461; 95% CI, 1.065–5.678; p = 0.035), a very severe non-motor symptoms burden (HR [hazard ratio] 2.828; 95% CI, 1.319–6.063; p = 0.008), falls (HR 3.966; 95% CI 1.757–8.470; p = 0.001), and dysphagia (HR 2.356; 95% CI 1.124–4.941; p = 0.023) was associated with AH after adjustment to age, gender, disease duration, levodopa equivalent daily dose, total number of non-antiparkinsonian drugs, and UPDRS-IIIOFF. Of the previous variables, only falls (HR 2.998; 95% CI 1.080–8.322; p = 0.035) was an independent predictor of AH. Conclusion: Falls is an independent predictor of AH in PD patients.

scholarly journals Parkinson’s disease: evolution of cognitive impairment and CSF Aβ1–42 profiles in a prospective longitudinal study

2018 ◽  
Vol 90 (2) ◽  
pp. 165-170 ◽  
Author(s):  
Stefanie Lerche ◽  
Isabel Wurster ◽  
Benjamin Röben ◽  
Gerrit Machetanz ◽  
Milan Zimmermann ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Impairment ◽  
Cox Regression ◽  
Disease Process ◽  
Amyloid Β ◽  
Prospective Longitudinal Study ◽  
Disease Evolution ◽  
Prospective Longitudinal

ObjectiveTo evaluate the evolution of cognitive impairment in relation to cerebrospinal fluid (CSF) profiles of amyloid-β (Aβ), total-Tau and phosphorylated-Tau in Parkinson’s disease (PD).MethodsProspective, longitudinal, observational study up to 10 years with follow-up every 2  years. We assessed CSF profiles in 415 patients with sporadic PD (median age 66; 63% men) and 142 healthy controls (median age 62; 43% men).ResultsPatients with PD with low CSF Aβ1–42 levels at baseline were more often cognitively impaired than patients with intermediate and high Aβ1–42 levels. Sixty-seven per cent of the patients with low Aβ1–42 levels at baseline and normal cognition developed cognitive impairment during follow-up, compared with 41% and 37% of patients having intermediate and high CSF Aβ1–42 levels. Kaplan-Meier survival curves and Cox regression revealed that patients with low CSF Aβ1–42 levels at baseline developed cognitive impairment more frequently and earlier during follow-up.ConclusionWe conclude that in patients with sporadic PD, low levels of Aβ1–42 are associated with a higher risk of developing cognitive impairment earlier in the disease process at least in a subgroup of patients.

scholarly journals Clinical Profile of Parkinson's Disease: Experience of Niger

2018 ◽  
Vol 09 (02) ◽  
pp. 214-218 ◽  
Author(s):  
Hamid Assadeck ◽  
Moussa Toudou Daouda ◽  
Fatimata Hassane Djibo ◽  
Djibo Douma Maiga ◽  
Eric Adehossi Omar
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Clinical Features ◽  
Outpatient Clinic ◽  
Clinical Profile ◽  
Stage Ii ◽  
Stage Iii ◽  
The Mean ◽  
Mean Time

ABSTRACT Background: Parkinson's disease (PD) is a chronic neurodegenerative pathology with unknown etiology. It is characterized clinically by the classic triad that associated tremors, bradykinesia, and rigidity. In Niger, there are no data on PD. Aims: We aimed to provide the demographic and clinical profile of PD in patients from Niger to create a database on PD in Niger. Patients and Methods: We conducted a retrospective study at the Neurology Outpatient Clinic of the Hôpital National de Niamey (HNN, Niger) over a period of 4.42 years from February 2009 to July 2013 collecting all cases of PD. The demographic and clinical features of all patients were collected and analyzed. Results: During the period of the study, 1695 patients consulted at the Neurology Outpatient Clinic of the HNN, among which 76 patients (4.48%) had secondary parkinsonism and 25 patients (1.47%) had features compatible with PD. Only patients with PD were included in this study. The mean age at onset of symptoms was 58 years (range: 42–74 years). The male sex was predominant (60%) with a sex ratio of 1.5. The mean time interval from the onset of symptoms to diagnosis of PD was 1.8 years (range: 1–5 years). The tremor was the most common symptom (84%). Bradykinesia represented 64% of the symptoms and rigidity 20%. At the time of the diagnosis of PD, 8 patients (32%) were in Stage I of the classification of Hoehn and Yahr, 16 patients (64%) in Stage II, and 1 patient (4%) in Stage III. The levodopa/carbidopa combination was the most used antiparkinsonian drug in our patients (88%). The mean time of follow-up of the patients was 2.5 years (range: 1–4.42 years). During the course of the disease, 9 patients (36%) were in Stage II of the classification of Hoehn and Yahr, 13 patients (52%) in Stage III, and 3 patients (12%) in Stage IV. Conclusion: Our study provides demographic and clinical data of PD in patients from Niger and shows that the hospital frequency of this disease is low (1.47%). The demographic and clinical features of our patients are similar to those of the patients of the prior studies reported in sub-Saharan Africa.

scholarly journals Blood–Brain Barrier Pathology in Alzheimer's and Parkinson's Disease: Implications for Drug Therapy

2007 ◽  
Vol 16 (3) ◽  
pp. 285-299 ◽  
Author(s):  
Brinda S. Desai ◽  
Angela J. Monahan ◽  
Paul M. Carvey ◽  
Bill Hendey
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Drug Therapy ◽  
Blood Brain Barrier ◽  
Brain Barrier ◽  
Blood Brain

scholarly journals Parkinson's disease: Impact of clinical and cognitive aspects on quality of life

2010 ◽  
Vol 4 (2) ◽  
pp. 131-137 ◽  
Author(s):  
Glória Maria Almeida Souza Tedrus ◽  
Lineu Correa Fonseca ◽  
Patrícia Mencaroni Kange
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Rating Scale ◽  
Signs And Symptoms ◽  
Well Being ◽  
Maternity Hospital ◽  
Related Factors ◽  
Significance Level

Abstract Parkinson's disease (PD) is a chronic disease manifested principally by motor signs and symptoms, but with frequent neuropsychological alterations. Objectives: To study the relationship between clinical and cognitive aspects and the perception of quality of life (QOL) in PD patients. Methods: Twenty consecutive patients (13 men) with idiopathic PD (mean age: 64.5y), mean disease time of 7.8 years and at stages 1-3 according to the modified Hoehn and Yahr staging scale (HYS), all outpatients from the Neurology Department of the Celso Pierro General and Maternity Hospital (PUC-Campinas), were analyzed. The following were applied: a clinical-neurological assessment, the Mini-Mental State Examination (MMSE), standard neuropsychological battery of the CERAD (Consortium to Establish a Registry for Alzheimer's Disease), Hamilton Depression Rating Scale (HAM-D) and a QOL questionnaire (Parkinson's Disease Questionnaire - PDQ-39). Statistical analysis was carried out at a significance level of p<0.05. Results: On the PDQ-39 under the sections total, mobility and activities of daily living, and the items motor compromise (HYS) and language of the MMSE were predictors of worse QOL. Verbal fluency was a factor for emotional well-being on the PDQ-39, whereas higher scores for HAM-D and worse performance on the item attention and calculation of the MMSE were associated with worse QOL in the social support section. Total score on the MMSE and educational level were QOL factors in cognition Conclusions: The findings of the present study suggest that clinical, cognitive, motor or other depression-related factors contribute differently to the domains of QOL.

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