Prognosis of Parkinson's disease: time to stage III, IV, V, and to motor fluctuations.
We report a long-term outcome on a large cohort of Japanese patients with Parkinson's disease (PD). A total of 1,768 (793 men, 975 women) consecutive patients visited our clinic from 1 January 1989 to 31 December 2002. Among them, 1,183 patients (531 men, 652 women) came to our clinic within 5 years from the onset of disease and at the Hoehn & Yahr Stage III or less at the first visit. Long-term outcome was evaluated in this subcohort of the patients. We examined the duration to reach Stage III, IV, and V, and the duration to develop wearing off and dyskinesia. Time to reach Stage III was slightly but significantly shorter in women, in that 23.8% of men and 35.3% of women reached Stage III by the end of the 5th year; 49.7% of men and 63.3% of women reached Stage III by the end of the 10th year, and 88.9% of men and 79.9% of women by the end of the 15th year (P < 0.001). Also, durations to develop wearing off and dyskinesia were shorter in women compared to men. These data suggest that the disease progression may be slightly faster for women. Young-onset patients showed significantly longer duration to reach Stage III, IV, and V but shorter duration to develop wearing off and dyskinesia. Not many studies are available in the literature on the long-term outcome of PD, and our data would be useful as a reference.
Sato
Kenichi
K
Department of Neurology, Juntendo University School of Medicine, Bunkyo, Tokyo, Japan.
Hatano
Taku
T
Yamashiro
Kazuo
K
Kagohashi
Maki
M
Nishioka
Kenya
K
Izawa
Nana
N
Mochizuki
Hideki
H
Hattori
Nobutaka
N
Mori
Hideo
H
Mizuno
Yoshikuni
Y
D000328:Adult; D000367:Age Factors; D000368:Aged; D000978:Antiparkinson Agents / Q000008:administration & dosage / Q000009:adverse effects; D015331:Cohort Studies; D004185:Disability Evaluation; D004359:Drug Therapy, Combination; D004409:Dyskinesia, Drug-Induced / Q000145:classification / Q000175:diagnosis / Q000453:epidemiology; D005260:Female; D006801:Humans; D007564:Japan; D007980:Levodopa / Q000008:administration & dosage / Q000009:adverse effects; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D009460:Neurologic Examination; D010300:Parkinson Disease / Q000145:classification / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012720:Severity of Illness Index; D012737:Sex Factors
D000978:Antiparkinson Agents; D007980:Levodopa