Assessment of Parkinson’s Disease symptoms and toxin exposures in firefighters: a cross-sectional survey

Abstract BACKGROUND: Parkinson’s disease (PD) has been correlated with several environmental and toxic exposures. The frequency of PD in firefighters is higher than the general population, which may be due to the high amounts of toxin exposures firefighters experience on the job. There is a need to further address the high rates of PD among this subgroup. The purpose of this study is to improve our understanding of the relationship between toxin exposure in firefighters and Parkinson’s Disease symptoms. METHODS: An anonymous survey distributed to Massachusetts firefighters assessed risk factors for toxin exposure and presence of PD symptoms. Risk factors included frequency and duration of time spent firefighting, number of fires worked, and history of toxin exposure (i.e., pesticides). We collected the frequency of PD symptoms including tremors, muscle stiffness, REM behavior disorder, hyposmia, micrographia, and decreased walking pace. Analyses comparing toxin exposure and presence of PD symptoms were performed using Chi-square testing, p < 0.05 was considered significant.RESULTS: Two hundred participants were included in the study. The number of years as a firefighter, the number of days per week working, and the number of fires worked correlated with higher reports of hyposmia, micrographia, and decreased walking pace.CONCLUSION: Firefighters have an increased risk for PD symptoms as a result of the toxin exposures that are frequently present in fires.

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Prevalence of Parkinson’s disease in China: a multicenter population-based survey

Neuroepidemiology ◽

10.1159/000520726 ◽

2021 ◽

Author(s):

Zhengyu Song ◽

Shuai Liu ◽

xiyu li ◽

Meilin Zhang ◽

Xiaodan Wang ◽

...

Keyword(s):

Risk Factors ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rural Areas ◽

Urban Areas ◽

Population Based ◽

Cluster Sampling ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Sleep Behavior

ABSTRACT Objective: Few data are available on the current prevalence of Parkinson's disease in China. The aim of this study was to determine the prevalence of Parkinson's disease in Chinese individuals aged 65 years and older and to analyze associated risk factors. Methods: We performed a population-based cross-sectional survey with a multistage cluster sampling design. Residents aged 65 and over were drawn from 11 urban districts and 10 rural counties across China. Data were entered into spreadsheets, and imported and analyzed using Statistical Package SPSS 24. Results: We identified 151 patients with Parkinson's disease among 8124 residents aged 65 and over, including 75 men (49.67%) and 76 women (50.33%). The overall prevalence of PD in the study population was 1.86% (95% confidence interval [CI]: 1.6%–2.2%), and the standardized prevalence of PD was 1.60%. The crude prevalence in men (2.12%) was higher than in women (1.66%), and standardized prevalence in urban areas (1.98%) was higher than in rural areas (1.48%). Logistic regression analysis showed that independent risk factors for PD were older age, heavy metal or pesticide exposure (odds ratio [OR]=3.83; 95% CI: 2.021–7.256), urban residence (OR=1.307; 95% CI: 1.041–1.642), rapid eye movement sleep behavior disorder (OR=1.450; 95% CI: 1.021–2.059), and heart disease (OR=2.431; 95% CI: 1.481–4.990). Conclusion：The prevalence of Parkinson's disease in individuals aged 65 and older in China has not increased significantly in recent years. The prevalence of Parkinson's disease is higher in men than in women and higher in urban areas than in rural areas.

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A Comparison of Pain between Parkinson’s Disease and Multiple System Atrophy: A Clinical Cross-Sectional Survey

Pain Research and Management ◽

10.1155/2019/3150306 ◽

2019 ◽

Vol 2019 ◽

pp. 1-6

Author(s):

He-Yang You ◽

Lei Wu ◽

Hai-Ting Yang ◽

Chen Yang ◽

Xiao-Ling Ding

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Multiple System Atrophy ◽

Rating Scale ◽

Depression Scale ◽

Healthy Controls ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Disease Rating ◽

Vas Scores

Background. Pain is frequent in Parkinson’s disease (PD) and Parkinson-plus syndrome. This study aimed to assess the prevalence, characteristics, therapy (especially the effect of dopaminergic therapy), and associated symptoms of pain in Parkinson's disease and multiple system atrophy (MSA) patients. Methods. Seventy-one PD patients, sixty-five MSA patients, and forty age-matched healthy controls were enrolled and evaluated by using the German pain questionnaire and visual analogue scale (VAS). In addition, the influence of pain in PD patients on anxiety, depression, and the quality of life was assessed with the Hospital Anxiety and Depression Scale (HADS) and Parkinson’s Disease Questionnaire (PDQ-39). Results. Compared to that of the healthy controls, the PD and MSA patients had a significantly higher presence of pain (P<0.01, P<0.01). PD patients had a higher presence of pain than MSA patients (P=0.007). No difference in VAS scores was observed between the PD and MSA patients (P=0.148). A total of 21 PD patients (42.85%) with pain and 13 MSA patients (43.33%) with pain received treatment. A total of 13 PD patients with pain and 6 MSA patients with pain had an improved pain intensity after using dopaminergic medication. The differences in the disease duration, Hoehn and Yahr stages, and scores on the Unified Parkinson’s Disease Rating Scale motor score, HAD-D, HAD-A, and PDQ-39 were significant between the PD patients with and without pain. Conclusion. PD and MSA patients are prone to pain with insufficient treatment. Pain interventions should be provided as soon as possible to improve the patient’s life.

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The “Gender Factor” in Wearing-Off among Patients with Parkinson’s Disease: A Post Hoc Analysis of DEEP Study

The Scientific World JOURNAL ◽

10.1155/2015/787451 ◽

2015 ◽

Vol 2015 ◽

pp. 1-10 ◽

Cited By ~ 20

Author(s):

Delia Colombo ◽

Giovanni Abbruzzese ◽

Angelo Antonini ◽

Paolo Barone ◽

Gilberto Bellia ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Cross Sectional Study ◽

Motor Symptom ◽

Cross Sectional ◽

Post Hoc Analysis ◽

Increased Risk ◽

Wearing Off ◽

Gender Factor ◽

Post Hoc

Background. The early detection of wearing-off in Parkinson disease (DEEP) observational study demonstrated that women with Parkinson’s disease (PD) carry an increased risk (80.1%) for wearing-off (WO). This post hoc analysis of DEEP study evaluates gender differences on WO and associated phenomena.Methods. Patients on dopaminergic treatment for ≥1 year were included in this multicenter observational cross-sectional study. In a single visit, WO was diagnosed based on neurologist assessment as well as the use of the 19-item wearing-off questionnaire (WOQ-19); WO was defined for scores ≥2. Post hoc analyses were conducted to investigate gender difference for demographic and clinical features with respect to WO.Results. Of 617 patients enrolled, 236 were women and 381 were men. Prevalence of WO was higher among women, according to both neurologists’ judgment (61.9% versus 53.8%,P=0.045) and the WOQ-19 analysis (72.5% versus 64.0%,P=0.034). In patients with WO (WOQ-19), women experienced ≥1 motor symptom in 72.5% versus 64.0% in men and ≥1 nonmotor symptom in 44.5% versus 36.7%, in men.Conclusions. Our results suggest WO as more common among women, for both motor and nonmotor symptoms. Prospective studies are warranted to investigate this potential gender-effect.

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Late onset depression: dopaminergic deficit and clinical features of prodromal Parkinson’s disease: a cross-sectional study

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2020-324266 ◽

2020 ◽

pp. jnnp-2020-324266

Author(s):

Hiba Kazmi ◽

Zuzana Walker ◽

Jan Booij ◽

Faraan Khan ◽

Sachit Shah ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Late Onset ◽

Emission Computed Tomography ◽

Imaging Features ◽

Cross Sectional ◽

Screening Questionnaire ◽

Imaging Results ◽

Increased Risk

BackgroundLate onset depression (LOD) may precede the diagnosis of Parkinson’s disease (PD) or dementia with Lewy bodies (DLB). We aimed to determine the rate of clinical and imaging features associated with prodromal PD/DLB in patients with LOD.MethodsIn a cross-sectional design, 36 patients with first onset of a depressive disorder (Diagnostic and Statistical Manual of Mental Disorders IV criteria) diagnosed after the age of 55 (LOD group) and 30 healthy controls (HC) underwent a detailed clinical assessment. In addition, 28/36 patients with LOD and 20/30 HC underwent a head MRI and 29/36 and 25/30, respectively, had dopamine transporter imaging by 123I-ioflupane single-photon emission computed tomography (SPECT) imaging. Image analysis of both scans was performed by a rater blind to the participant group. Results of clinical assessments and imaging results were compared between the two groups.ResultsPatients with LOD (n=36) had significantly worse scores than HC (n=30) on the PD screening questionnaire (mean (SD) 1.8 (1.9) vs 0.8 (1.2); p=0.01), Movement Disorder Society Unified Parkinson’s Disease Rating Scale total (mean (SD) 19.2 (12.7) vs 6.1 (5.7); p<0.001), REM-sleep behaviour disorder screening questionnaire (mean (SD) 4.3 (3.2) vs 2.1 (2.1); p=0.001), Lille Apathy Rating Scale (mean (SD) −23.3 (9.6) vs −27.0 (4.7); p=0.04) and the Scales for Outcomes in PD-Autonomic (mean (SD) 14.9 (8.7) vs 7.7 (4.9); p<0.001). Twenty-four per cent of patients with LOD versus 4% HC had an abnormal 123I-ioflupane SPECT scan (p=0.04).ConclusionsLOD is associated with increased rates of motor and non-motor features of PD/DLB and of abnormal 123I-ioflupane SPECTs. These results suggest that patients with LOD should be considered at increased risk of PD/DLB.

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THUR 116 Vascular prevention in patients with parkinson’s disease

Journal of Neurology Neurosurgery & Psychiatry ◽

10.1136/jnnp-2018-abn.45 ◽

2018 ◽

Vol 89 (10) ◽

pp. A12.3-A12

Author(s):

Kempe Isla ◽

Grosset Katherine A ◽

Grosset Donald G

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Primary Prevention ◽

Statin Therapy ◽

Statin Treatment ◽

Vascular Risk ◽

Vascular Events ◽

Cross Sectional ◽

Increased Risk ◽

Cognitive Problems

BackgroundVascular prevention is appropriate for patients with a vascular history (secondary prevention) and increased risk (primary prevention). Cerebrovascular disease adds to gait and cognitive problems in patients with Parkinson’s disease (PD).MethodsA convenience cross-sectional sample of consecutive PD patients attending the Neurology Movement Disorder clinic was assessed, and QRISK3 scored when appropriate (cases without vascular events, age <85 years).ResultsOf 100 cases, mean age 66.5 (SD 9.0) years, 52.0% male, with PD duration 8.3 (SD 5.5) years, 15 had a vascular history meriting statin therapy, of whom 12 (80.0%) were prescribed statins. 22 had a high vascular risk (QRISK3 >20%), mean QRISK3 28.6 (SD 7.7) of whom 2 (9.1%) were prescribed statins. We are now actively assessing QRISK3 and recommending statin therapy where appropriate.ConclusionsSecondary vascular prevention with statins is more commonly implemented than primary prevention, in patients with PD. In patients without a vascular diagnosis, vascular risk should be assessed and statin therapy offered where appropriate, noting that around one-fifth of patients have a high vascular risk and are not on statin treatment.

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Parkinson’s Disease and Symptomatic Osteoarthritis Are Independent Risk Factors of Falls in the Elderly

Clinical Medicine Insights Arthritis and Musculoskeletal Disorders ◽

10.1177/1179544119884936 ◽

2019 ◽

Vol 12 ◽

pp. 117954411988493 ◽

Cited By ~ 2

Author(s):

Anneli Teder-Braschinsky ◽

Aare Märtson ◽

Marika Rosenthal ◽

Pille Taba

Keyword(s):

Risk Factors ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Knee Osteoarthritis ◽

The Elderly ◽

Control Group ◽

Increased Risk ◽

Symptomatic Knee ◽

Risk Of Falls ◽

Risk Factors For Falls

Objectives: Deteriorating functionality and loss of mobility, resulting from Parkinson’s disease, may be worsened by osteoarthritis, which is the most common form of joint disease causing pain and functional impairment. We assessed the association between symptomatic hip or knee osteoarthritis, falls, and the ability to walk among patients with Parkinson’s disease compared to a control group. Methods: A total of 136 patients with Parkinson’s disease in Southern Estonia and 142 controls with an average age of 76.8 and 76.3 years, respectively, were enrolled in a retrospective case-control study. Information on falls and related fractures during the previous year was collected from the patients with Parkinson’s disease and controls. Covariates included gender, age, mobility, duration of Parkinson’s disease, and fractures. Results: Patients with Parkinson’s disease were at an increased risk of falls compared to the control group, and for the higher risk of fractures. Symptomatic knee or hip osteoarthritis was a significant independent predictor of falls in both patients with Parkinson’s disease and controls. The higher risk for fractures during the previous year was demonstrated in symptomatic osteoarthritis. Risk factors for falls included also female gender, use of sleep pills, and the inability to walk 500 m. Conclusions: Symptomatic hip and knee osteoarthritis are risk factors for falls and related fractures among the elderly population with and without Parkinson’s disease. The inability to walk 500 m could be used as a simple predictive factor for the increased risk of falls among elderly populations.

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Prevalence of Type 2 Diabetes and Associated Risk Factors Among Saharawi Refugees (P10-071-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz034.p10-071-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Sigrun Henjum ◽

Victoria Telle Hjellset ◽

Marte Karoline Raberg Kjollesdal ◽

Merethe Flaaten ◽

Eivind Andersen ◽

...

Keyword(s):

Risk Factors ◽

Type 2 Diabetes ◽

Waist Circumference ◽

Overweight And Obesity ◽

Refugee Camps ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Increased Risk ◽

Associated Risk Factors

Abstract Objectives Economic development, globalization and urbanization has resulted in a shift in dietary consumption and energy expenditure in low- and middle-income countries, called the Nutrition Transition. At the same time, the prevalence of type 2 diabetes (T2D) and associated co-morbidities are rising worldwide. The Saharawi refugees have been living in refugee camps in the Algerian desert since 1975 and are totally dependent on food aid. High prevalence of overweight and obesity has been reported among Saharawi women. Limited knowledge about the prevalence of T2D and associated risk factors exists in this population; therefore, the aim with this study was to address this gap in the literature. Methods A cross-sectional survey was carried out in five Saharawi refugee camps, in Algeria and 180 women and 175 men were randomly selected. Participants’ blood glucose levels was assessed by HbA1c measurements and diagnosed with diabetes if HbA1c ≥48 mmol/mol and prediabetes if HbA1c was between 42–47 mmol/mol. The Finnish Diabetes Risk Score (FINDRISK) was used to assess various risk factors for T2D. Results Mean HbA1c among the Saharawi refugees was 38 mmol/mol. Seven and 15% were diagnosed with T2D and prediabetes, respectively, and 26% and 19% were overweight and obese, respectively. According to FINDRISK, 9% of the participants had high risk of developing diabetes, 10% had moderate risk, 37% had some risk and 44% had low risk. In multiple logistic regression models, after controlling for age, gender, number of children, BMI and education, the strongest predictor for diabetes was waist circumference, OR (95% CI): 1.1 (1.0, 1.1). The strongest predictor for prediabetes was age and waist circumference OR (95% CI): 1.0 (1.0, 1.1) and OR (95% CI): 1.1 (1.0, 1.1), respectively. Conclusions We found moderate prevalence of diabetes among the Saharawi refugees; however a high proportion had prediabetes and were suffering from overweight and obesity. In light of this, the rates of T2D are likely to increase dramatically in the near future. The Saharawi health authorities should pay attention to the increased risk of diabetes in this in this vulnerable population. Funding Sources Oslo Metropolitan University.

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Risk of Falls in Parkinson’s Disease: A Cross-Sectional Study of 160 Patients

Parkinson s Disease ◽

10.1155/2012/362572 ◽

2012 ◽

Vol 2012 ◽

pp. 1-10 ◽

Cited By ~ 19

Author(s):

Ana Contreras ◽

Francisco Grandas

Keyword(s):

Risk Factors ◽

Parkinson’S Disease ◽

Parkinson's Disease ◽

Disease Risk ◽

Cross Sectional Study ◽

Operating Characteristics ◽

Balance Test ◽

Cross Sectional ◽

Risk Of Falls ◽

Risk Factors For Falling

Falls are a major source of disability in Parkinson’s disease. Risk factors for falling in Parkinson’s disease remain unclear. To determine the relevant risk factors for falling in Parkinson’s disease, we screened 160 consecutive patients with Parkinson’s disease for falls and assessed 40 variables. A comparison between fallers and nonfallers was performed using statistical univariate analyses, followed by bivariate and multivariate logistic regression, receiver-operating characteristics analysis, and Kaplan-Meier curves. 38.8% of patients experienced falls since the onset of Parkinson’s disease (recurrent in 67%). Tinetti Balance score and Hoehn and Yahr staging were the best independent variables associated with falls. The Tinetti Balance test predicted falls with 71% sensitivity and 79% specificity and Hoehn and Yahr staging with 77% sensitivity and 71% specificity. The risk of falls increased exponentially with age, especially from 70 years onward. Patients aged >70 years at the onset of Parkinson’s disease experienced falls significantly earlier than younger patients.

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Risk of Fall for Individuals With Intellectual Disability

American Journal on Intellectual and Developmental Disabilities ◽

10.1352/1944-7558-114.4:225-236 ◽

2009 ◽

Vol 114 (4) ◽

pp. 225-236 ◽

Cited By ~ 50

Author(s):

Yoichi Chiba ◽

Atsuyoshi Shimada ◽

Futoshi Yoshida ◽

Hiromi Keino ◽

Mariko Hasegawa ◽

...

Keyword(s):

Risk Factors ◽

Cutoff Score ◽

Cross Sectional Survey ◽

Cross Sectional ◽

Japanese Adults ◽

Increased Risk ◽

Independent Risk Factors ◽

Adults With Intellectual Disabilities ◽

Risk Of Fall ◽

Risk Factors For Falling

Abstract Our aim was to identify risk factors for falling and establish a method to assess risk for falls in adults with intellectual disabilities. In a cross-sectional survey of 144 Japanese adults, we found that age, presence of epilepsy, and presence of paretic conditions were independent risk factors. The Tinetti balance and gait instrument was successfully administered to this population and resulted in high diagnostic accuracy (sensitivity 88.9%, specificity 91.9%) for identifying individuals at risk when the cutoff score was set at 25. Participants whose balance and gait deteriorated showed a decrease in the Tinetti score of at least 2 points per year. Thus, the Tinetti instrument may be an effective tool to detect an increased risk of fall in this population.

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Associations between probable REM sleep behavior disorder, olfactory disturbance, and clinical symptoms in Parkinson’s disease: A multicenter cross-sectional study

PLoS ONE ◽

10.1371/journal.pone.0247443 ◽

2021 ◽

Vol 16 (2) ◽

pp. e0247443

Author(s):

Mutsumi Iijima ◽

Yasuyuki Okuma ◽

Keisuke Suzuki ◽

Fumihito Yoshii ◽

Shigeru Nogawa ◽

...

Keyword(s):

Parkinson’S Disease ◽

Parkinson's Disease ◽

Rating Scale ◽

Clinical Symptoms ◽

Rem Sleep Behavior Disorder ◽

Behavior Disorder ◽

Olfactory Dysfunction ◽

Olfactory Function ◽

Cross Sectional ◽

Sleep Behavior

Background Rapid eye movement sleep behavior disorder (RBD) and olfactory dysfunction are useful for early diagnosis of Parkinson’s disease (PD). RBD and severe olfactory dysfunction are also regarded as risk factors for cognitive impairment in PD. This study aimed to assess the associations between RBD, olfactory function, and clinical symptoms in patients with PD. Methods The participants were 404 patients with non-demented PD. Probable RBD (pRBD) was determined using the Japanese version of the RBD screening questionnaire (RBDSQ-J) and the RBD Single-Question Screen (RBD1Q). Olfactory function was evaluated using the odor identification test for Japanese. Clinical symptoms were evaluated using the Movement Disorder Society Revision of the Unified PD Rating Scale (MDS-UPDRS) parts I–IV. Results In total, 134 (33.2%) patients indicated a history of pRBD as determined by the RBD1Q and 136 (33.7%) by the RBDSQ-J based on a cutoff value of 6 points. Moreover, 101 patients were diagnosed as pRBD by both questionnaires, 35 by the RBDSQ-J only, and 33 by the RBD1Q only. The MDS-UPDRS parts I–III scores were significantly higher and disease duration significantly longer in the pRBD group. pRBD was significantly associated with male gender and the MDS-UPDRS part I score. The olfactory identification function was significantly reduced in the pRBD group. Conclusions About 33% of the patients with PD had pRBD based on the questionnaires, and both motor and non-motor functions were significantly decreased in these patients. These results suggest that more extensive degeneration occurred in patients with non-demented PD with RBD.

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