title: Motor profile and drug treatment of nursing home residents with Parkinson's disease.
abstract: OBJECTIVE
  To examine the clinical characteristics, motor impairments, and drug treatments of nursing home residents with Parkinson's disease (PD).
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Nursing homes in the southeast of the Netherlands.
  
  
  METHODS
  Nursing home residents with PD and a Mini-Mental State Examination score of 18 or greater seen by a physician with experience in movement disorders.
  
  
  METHODS
  Participant characteristics, motor function, and dopaminergic medications were assessed. The Short Parkinson's Evaluation Scale/SCales for Outcomes in Parkinson's disease (SPES-SCOPA) was used to assess motor impairments and disabilities.
  
  
  RESULTS
  Seventy-three nursing home residents with PD (mean age 78.7; 45% male; mean disease duration 10.1 years; Hoehn and Yahr 4 (38%) and 5 (49%)) were included. Most residents were severely disabled, 49% being wheelchair bound. According to the SPES-SCOPA, 44% of residents were "off" (in a motor state in which they are slow and stiff) most of the time. Dyskinesias were encountered infrequently. Most residents were mainly treated with levodopa monotherapy, and daily doses varied widely (20-1,600 mg, mean 673 mg); 25% of residents were treated with less than 400 mg levodopa daily, and 8% received no levodopa at all. The movement disorders specialist considered 32 residents to be possibly undertreated.
  
  
  CONCLUSIONS
  These findings show that PD in nursing home residents is characterized by severe motor impairment and a high proportion of daily "off" time, which underscores the need for better management of PD in nursing homes, for example within specialized institutions or with periodic consultations by a movement disorders expert.
authors.affiliation: Department of Neurology, Atrium Medical Center, Heerlen, the Netherlands. nicoweerkamp@hotmail.com
authors.forename: Nico J
authors.initials: NJ
authors.lastname: Weerkamp
authors.forename: Sytse U
authors.initials: SU
authors.lastname: Zuidema
authors.forename: Gerrit
authors.initials: G
authors.lastname: Tissingh
authors.forename: Petra J E
authors.initials: PJ
authors.lastname: Poels
authors.forename: Marten
authors.initials: M
authors.lastname: Munneke
authors.forename: Raymond T C M
authors.initials: RT
authors.lastname: Koopmans
authors.forename: Bastiaan R
authors.initials: BR
authors.lastname: Bloem
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D020820:Dyskinesias / Q000150:complications / Q000503:physiopathology; D005260:Female; D006801:Humans; D007980:Levodopa / Q000627:therapeutic use; D008297:Male; D009735:Nursing Homes; D010300:Parkinson Disease / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D007980:Levodopa