scholarly journals Rate of Hospitalizations and Underlying Reasons Among People with Parkinson’s Disease: Population-Based Cohort Study in UK Primary Care

2021 ◽  
pp. 1-10
Author(s):  
Olaitan Okunoye ◽  
Laura Horsfall ◽  
Louise Marston ◽  
Kate Walters ◽  
Anette Schrag
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Large Scale ◽  
Social Deprivation ◽  
Age Groups ◽  
Geographic Location ◽  
Hospitalization Rate ◽  
Health Improvement ◽  
Gastrointestinal Complications

Background: Hospitalization in Parkinson’s disease (PD) is associated with reduced quality of life, caregiver burden and high costs. However, no large-scale studies of rate and causes of hospitalizations in patients with PD have been published. Objective: To investigate the rate and reasons for hospitalization and factors associated with hospitalization among people with PD compared to the general population. Methods: We examined rate and causes of admission in PD patients and matched controls in The Health Improvement Network from 2006 to 2016. Multivariable Poisson regression was used to explore the effects of age, gender, social deprivation, urbanicity and practice geographic location on hospitalization. Results: In longitudinal data from 9,998 newly diagnosed individuals with PD and 55,554 controls without PD aged≥50years, 39%of PD patients and 28%of controls were hospitalised over a median follow-up 5.1years. The adjusted incidence rate ratio(IRR) of hospitalization in PD compared to controls was 1.33(95%CI:1.29–1.37) and rose with increased follow-up duration. Hospitalization rate was overall higher in the older age groups, but the adjusted IRR of hospitalization compared to controls was highest in the youngest age group. PD patients were more often admitted with falls/fractures, infections, gastrointestinal complications, PD, dementia, psychosis/hallucinations, postural hypotension, electrolyte disturbances, stroke and surgical procedures and slightly less often due to hypertension. Conclusion: People with PD have an increased hospitalization rate compared to controls, particularly in the younger age groups, and it increases with longer disease duration. The complications of motor and non-motor features of PD are amongst the main reasons for admission, some of which could be managed preventatively to avoid admissions.

scholarly journals Age Matters: Objective Gait Assessment in Early Parkinson’s Disease Using an RGB-D Camera

2019 ◽  
Vol 2019 ◽  
pp. 1-9
Author(s):  
Beatriz Muñoz Ospina ◽  
Jaime Andrés Valderrama Chaparro ◽  
Juan David Arango Paredes ◽  
Yor Jaggy Castaño Pino ◽  
Andrés Navarro ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Low Cost ◽  
Objective Assessment ◽  
Descriptive Analysis ◽  
Age Groups ◽  
Rank Correlation ◽  
Depth Sensing ◽  
Gait Dynamics

Background. Gait alterations are hallmarks for the diagnosis and follow-up of patients with Parkinson’s disease (PD). In normal conditions, age could affect gait dynamics. Although it is known that objective assessment of gait is a valuable tool for diagnosis and follow-up of patients with PD, only few studies evaluate the effect of aging on the gait pattern of patients with PD. Objective. The purpose of this study was to assess differences in gait dynamics between PD patients and healthy subjects and to investigate the effects of aging on these differences using a low-cost RGB-D depth-sensing camera. Methods. 30 PD patients and 30 age-matched controls were recruited. Descriptive analysis was used for clinical variables, and Spearman’s rank correlation was used to correlate age and gait variables. The sample was distributed in age groups; then, Mann–Whitney U test was used for comparison of gait variables between groups. Results. PD patients exhibited prolonged swing (p=0.002) and stance times (p<0.001) and lower speed values (p<0.001) compared to controls. This was consistent in all age groups, except for the one between 76 and 88 years old, in which the controls were slower and had longer swing and stance times. These results were statically significant for the group from 60 to 66 years. Conclusion. Gait speed, swing, and stance times are useful for differentiating PD patients from controls. Quantitative gait parameters measured by an RGB-D camera can complement clinical assessment of PD patients. The analysis of these spatiotemporal variables should consider the age of the subject.

scholarly journals The Parkinson’s Disease GWAS Locus Browser

2020 ◽  
Author(s):  
Francis P. Grenn ◽  
Jonggeol J. Kim ◽  
Mary B. Makarious ◽  
Hirotaka Iwaki ◽  
Anastasia Illarionova ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Large Scale ◽  
Association Studies ◽  
Age At Onset ◽  
Genome Wide Association Studies ◽  
Functional Studies ◽  
Risk Variants ◽  
Genome Wide

AbstractParkinson’s disease (PD) is a neurodegenerative disease with an often complex genetic component identifiable by genome-wide association studies (GWAS). The most recent large scale PD GWASes have identified more than 90 independent risk variants for PD risk and progression across 80 loci. One major challenge in current genomics is identifying the causal gene(s) and variant(s) from each GWAS locus. Here we present a GWAS locus browser application that combines data from multiple databases to aid in the prioritization of genes associated with PD GWAS loci. We included 92 independent genome-wide significant signals from multiple recent PD GWAS studies including the PD risk GWAS, age-at-onset GWAS and progression GWAS. We gathered data for all 2336 genes within 1Mb up and downstream of each variant to allow users to assess which gene(s) are most associated with the variant of interest based on a set of self-ranked criteria. Our aim is that the information contained in this browser (https://pdgenetics.shinyapps.io/GWASBrowser/) will assist the PD research community with the prioritization of genes for follow-up functional studies and as potential therapeutic targets.

scholarly journals Differences in the presentation and progression of Parkinson’s disease by sex

2020 ◽  
Author(s):  
Hirotaka Iwaki ◽  
Cornelis Blauwendraat ◽  
Hampton L. Leonard ◽  
Mary B. Makarious ◽  
Jonggeol J. Kim ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Large Scale ◽  
Rating Scale ◽  
Underlying Mechanism ◽  
Future Research ◽  
Disease Heterogeneity ◽  
Cox Models ◽  
Logistic Regression Models

AbstractObjectivesIdentifying the contribution of biological sex to the heterogeneity in presentation and progression of Parkinson’s disease (PD).BackgroundThe different prevalence of Parkinson’s disease (PD) in men and women suggests that sex-associated mechanisms influence disease mechanisms. Investigating the contribution of sex to disease heterogeneity may uncover disease processes, and lead to new therapeutic targets. Also, understanding these differences in phenotypes will result in better patient management and the planning of more efficient clinical trials.MethodsWe tested 40 clinical phenotypes using longitudinal clinic-based patient cohorts consisting of 5,946 patients with a median follow-up of 3.1 years. For continuous outcomes, we used linear regressions at baseline to test the sex-associated differences in presentation, and linear mixed-effects models to test the sex-associated differences in progression. For binomial outcomes, we used logistic regression models at baseline and Cox models for survival analyses. We adjusted for age, disease duration and dopaminergic medication usage. In the secondary analyses, data from 28,809 PD patients and 10,556 non-PD participants from Fox Insight, an online-only self-assessment cohort for PD research, were analyzed to check whether the sex-associated differences observed in the primary analyses were consistent in the cohort and whether the differences were unique to PD or not.ResultsFemale PD patients had a higher risk for developing dyskinesia early during the follow-up period; with a slower progression in their difficulties of activities of daily living as measured by the Unified Parkinson’s Disease Rating Scale Part II (classic/MDS-revised version); and a lower risk of developing cognitive impairment than male patients. The findings in the longitudinal clinic-based cohorts were mostly consistent with the results in the online-only cohort.ConclusionsThis large-scale analysis observed the sex contribution to the heterogeneity of Parkinson’s disease. The results highlight the necessity of future research of the underlying mechanism and importance of personalized clinical management.

Coexistent Osteoarthritis and Parkinson’s Disease: Data from the Parkinson’s Foundation Outcomes Project

2020 ◽  
Vol 10 (4) ◽  
pp. 1601-1610
Author(s):  
Jaimie A. Roper ◽  
Abigail C. Schmitt ◽  
Hanzhi Gao ◽  
Ying He ◽  
Samuel Wu ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Study Data ◽  
Functional Mobility ◽  
Quality Improvement Initiative ◽  
Timed Up And Go ◽  
Mobility Performance ◽  
Risk Of Mortality ◽  
The Impact

Background: The impact of concurrent osteoarthritis on mobility and mortality in individuals with Parkinson’s disease is unknown. Objective: We sought to understand to what extent osteoarthritis severity influenced mobility across time and how osteoarthritis severity could affect mortality in individuals with Parkinson’s disease. Methods: In a retrospective observational longitudinal study, data from the Parkinson’s Foundation Quality Improvement Initiative was analyzed. We included 2,274 persons with Parkinson’s disease. The main outcomes were the effects of osteoarthritis severity on functional mobility and mortality. The Timed Up and Go test measured functional mobility performance. Mortality was measured as the osteoarthritis group effect on survival time in years. Results: More individuals with symptomatic osteoarthritis reported at least monthly falls compared to the other groups (14.5% vs. 7.2% without reported osteoarthritis and 8.4% asymptomatic/minimal osteoarthritis, p = 0.0004). The symptomatic group contained significantly more individuals with low functional mobility (TUG≥12 seconds) at baseline (51.5% vs. 29.0% and 36.1%, p < 0.0001). The odds of having low functional mobility for individuals with symptomatic osteoarthritis was 1.63 times compared to those without reported osteoarthritis (p < 0.0004); and was 1.57 times compared to those with asymptomatic/minimal osteoarthritis (p = 0.0026) after controlling pre-specified covariates. Similar results hold at the time of follow-up while changes in functional mobility were not significant across groups, suggesting that osteoarthritis likely does not accelerate the changes in functional mobility across time. Coexisting symptomatic osteoarthritis and Parkinson’s disease seem to additively increase the risk of mortality (p = 0.007). Conclusion: Our results highlight the impact and potential additive effects of symptomatic osteoarthritis in persons with Parkinson’s disease.

scholarly journals Present and Future of Parkinson’s Disease in Spain: PARKINSON-2030 Delphi Project

2021 ◽  
Vol 11 (8) ◽  
pp. 1027
Author(s):  
Diego Santos García ◽  
Marta Blázquez-Estrada ◽  
Matilde Calopa ◽  
Francisco Escamilla-Sevilla ◽  
Eric Freire ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
New Technologies ◽  
Management Strategies ◽  
Multidisciplinary Teams ◽  
Modified Delphi ◽  
Advanced Stages ◽  
Diagnostic Capacity ◽  
Socio Economic Impact

Parkinson’s disease (PD) is a chronic progressive and irreversible disease and the second most common neurodegenerative disease worldwide. In Spain, it affects around 120.000–150.000 individuals, and its prevalence is estimated to increase in the future. PD has a great impact on patients’ and caregivers’ lives and also entails a substantial socioeconomic burden. The aim of the present study was to examine the current situation and the 10-year PD forecast for Spain in order to optimize and design future management strategies. This study was performed using the modified Delphi method to try to obtain a consensus among a panel of movement disorders experts. According to the panel, future PD management will improve diagnostic capacity and follow-up, it will include multidisciplinary teams, and innovative treatments will be developed. The expansion of new technologies and studies on biomarkers will have an impact on future PD management, leading to more accurate diagnoses, prognoses, and individualized therapies. However, the socio-economic impact of the disease will continue to be significant by 2030, especially for patients in advanced stages. This study highlighted the unmet needs in diagnosis and treatment and how crucial it is to establish recommendations for future diagnostic and therapeutic management of PD.

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 Extradural Motor Cortex Stimulation in Parkinson’s Disease: Long-Term Clinical Outcome

2021 ◽  
Vol 11 (4) ◽  
pp. 416
Author(s):  
Carla Piano ◽  
Francesco Bove ◽  
Delia Mulas ◽  
Enrico Di Stasio ◽  
Alfonso Fasano ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Cortex ◽  
Clinical Outcome ◽  
Motor Cortex Stimulation ◽  
Dopaminergic Therapy

Previous investigations have reported on the motor benefits and safety of chronic extradural motor cortex stimulation (EMCS) for patients with Parkinson’s disease (PD), but studies addressing the long-term clinical outcome are still lacking. In this study, nine consecutive PD patients who underwent EMCS were prospectively recruited, with a mean follow-up time of 5.1 ± 2.5 years. As compared to the preoperatory baseline, the Unified Parkinson’s Disease Rating Scale (UPDRS)-III in the off-medication condition significantly decreased by 13.8% at 12 months, 16.1% at 18 months, 18.4% at 24 months, 21% at 36 months, 15.6% at 60 months, and 8.6% at 72 months. The UPDRS-IV decreased by 30.8% at 12 months, 22.1% at 24 months, 25% at 60 months, and 36.5% at 72 months. Dopaminergic therapy showed a progressive reduction, significant at 60 months (11.8%). Quality of life improved by 18.0% at 12 months, and 22.4% at 60 months. No surgical complication, cognitive or behavioral change occurred. The only adverse event reported was an infection of the implantable pulse generator pocket. Even in the long-term follow-up, EMCS was shown to be a safe and effective treatment option in PD patients, resulting in improvements in motor symptoms and quality of life, and reductions in motor complications and dopaminergic therapy.

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