Parkinson's disease as community health problem: study in Norwegian nursing homes. The Norwegian Study Group of Parkinson's Disease in the Elderly.
OBJECTIVE
To examine the extent of under-diagnosis and overdiagnosis of Parkinson's disease and to determine quality of treatment in a defined population.


METHODS
Clinical evaluation of an elderly population.


METHODS
40 Norwegian nursing homes.


METHODS
3322 residents of nursing homes, of whom 500 were selected by nursing staff for evaluation on the basis of a structured information programme on Parkinson's disease and 269 were examined in detail by neurologists.


METHODS
Patients' scores on clinical rating scales, diagnosis of parkinsonism, and effect of changing drug treatment.


RESULTS
169 (5.1%) patients were found to have clinical idiopathic Parkinson's disease, 31 of whom had not had the disease diagnosed previously. In addition, 31 patients without the disease were taking antiparkinsonian drugs unnecessarily. Eighty patients were judged to be receiving "optimal" treatment. In the remaining 58, the treatment was changed, and 36 patients showed a definite functional improvement after a 12 week observation period.


CONCLUSIONS
The quality of life of many elderly patients with Parkinson's disease could be improved by increasing medical and neurological services.
Larsen
J P
JP
Department of Neurology, Central Hospital of Rogaland, Stavanger, Norway.
D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003937:Diagnosis, Differential; D003951:Diagnostic Errors; D005260:Female; D006707:Homes for the Aged / Q000592:standards*; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D009664:Norway / Q000453:epidemiology; D009735:Nursing Homes / Q000592:standards*; D010300:Parkinson Disease / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D015995:Prevalence; D011788:Quality of Life
D007980:Levodopa