title: Determinants of delayed diagnosis in Parkinson's disease.
abstract: The early and accurate diagnosis of Parkinson's disease (PD) is the first step towards optimal patient management. The aim of this study was to investigate the major determinants of delayed diagnosis in PD. We recruited a population-representative cohort of 239 newly-diagnosed PD patients who underwent clinical and neuropsychological evaluation. Non-parametric methods were used to define the factors associated with diagnostic delay. The median time from motor symptom onset to primary care physician (PCP) presentation was considerably longer than the time from PCP presentation to PD diagnosis (11 vs. 1 months). Male sex and presenting motor phenotype were independently associated with delayed PCP presentation on Cox regression analysis. Patients presenting with gait disturbance experienced the longest delay, whilst those presenting with tremor had the shortest. In summary, male sex and presenting motor phenotype are key determinants of delayed diagnosis in PD.
authors.affiliation: Centre for Brain Repair, University of Cambridge, ED Adrian Building, Forvie Site, Robinson Way, Cambridge, CB2 0PY, UK. dpbreen1@gmail.com
authors.forename: David P
authors.initials: DP
authors.lastname: Breen
authors.forename: Jonathan R
authors.initials: JR
authors.lastname: Evans
authors.forename: Krista
authors.initials: K
authors.lastname: Farrell
authors.forename: Carol
authors.initials: C
authors.lastname: Brayne
authors.forename: Roger A
authors.initials: RA
authors.lastname: Barker
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000978:Antiparkinson Agents / Q000627:therapeutic use; D015331:Cohort Studies; D057210:Delayed Diagnosis / Q000706:statistics & numerical data*; D005260:Female; D020233:Gait Disorders, Neurologic / Q000175:diagnosis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000503:physiopathology; D010641:Phenotype; D011153:Population; D011320:Primary Health Care / Q000706:statistics & numerical data; D012044:Regression Analysis; D012737:Sex Factors; D012959:Socioeconomic Factors; D014202:Tremor / Q000175:diagnosis / Q000209:etiology
chemical_list: D000978:Antiparkinson Agents