title: Mortality of Parkinson's disease by Hoehn-Yahr stage from community-based and clinic series [Keelung Community-based Integrated Screening (KCIS) no. 17)].
abstract: OBJECTIVE
  We aimed to quantify the mortality reduction by which the early detection of Parkinson's disease (PD) within a community-based study could reduce the number of advanced cases.
  
  
  METHODS
  Data used in this study were derived from two community-based surveys and from a clinical series of PD cases identified from a medical centre. The cumulative survival by Hoehn-Yahr (H-Y) scale was estimated and the mortality reduction derived from a community-based survey was predicted.
  
  
  RESULTS
  A total of 117 PD patients were detected through two community-based approaches. By comparing the H-Y stage distribution of screen-detected cases with those from the clinical series, a 22.5% excess in the number of early PD (H-Y stage I and stage II) were identified with screening. The risk ratios of being H-Y stage III or severe for community-based detected cases versus clinical series were 0.49 (95% confidence interval: 0.30-0.78). The total death rate adjusted by H-Y stage distribution was 21% and 28% for cases from community and clinical series, respectively.
  
  
  CONCLUSIONS
  The present study revealed that early detection of PD through a community-based survey may reduce 51% incidence of stage III or more severe PD at diagnosis, leading to a 25% reduction in mortality.
authors.affiliation: Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: Horng-Huei
authors.initials: HH
authors.lastname: Liou
authors.forename: Chia-Yun
authors.initials: CY
authors.lastname: Wu
authors.forename: Yueh-Hsia
authors.initials: YH
authors.lastname: Chiu
authors.forename: Amy Ming-Fang
authors.initials: AM
authors.lastname: Yen
authors.forename: Rong-Chi
authors.initials: RC
authors.lastname: Chen
authors.forename: Ta-Fu
authors.initials: TF
authors.lastname: Chen
authors.forename: Chih-Chuan
authors.initials: CC
authors.lastname: Chen
authors.forename: Yuarn-Chung
authors.initials: YC
authors.lastname: Hwang
authors.forename: Ying-Rong
authors.initials: YR
authors.lastname: Wen
authors.forename: Tony Hsiu-Hsi
authors.initials: TH
authors.lastname: Chen
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D042241:Early Diagnosis; D005260:Female; D019538:Health Care Surveys; D006801:Humans; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D009026:Mortality / Q000639:trends*; D010300:Parkinson Disease / Q000145:classification / Q000175:diagnosis* / Q000209:etiology / Q000401:mortality*; D016016:Proportional Hazards Models; D012720:Severity of Illness Index; D016019:Survival Analysis; D013624:Taiwan / Q000453:epidemiology