Mortality of Parkinson's disease by Hoehn-Yahr stage from community-based and clinic series [Keelung Community-based Integrated Screening (KCIS) no. 17)].
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.
Liou
Horng-Huei
HH
Department of Neurology, National Taiwan University Hospital, Taipei, Taiwan.
Wu
Chia-Yun
CY
Chiu
Yueh-Hsia
YH
Yen
Amy Ming-Fang
AM
Chen
Rong-Chi
RC
Chen
Ta-Fu
TF
Chen
Chih-Chuan
CC
Hwang
Yuarn-Chung
YC
Wen
Ying-Rong
YR
Chen
Tony Hsiu-Hsi
TH
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