title: Risk factors and predictors of levodopa-induced dyskinesia among multiethnic Malaysians with Parkinson's disease.
abstract: Chronic pulsatile levodopa therapy for Parkinson's disease (PD) leads to the development of motor fluctuations and dyskinesia. We studied the prevalence and predictors of levodopa-induced dyskinesia among multiethnic Malaysian patients with PD.
  
  
  METHODS
  This is a cross-sectional study involving 95 patients with PD on uninterrupted levodopa therapy for at least 6 months. The instrument used was the UPDRS questionnaires. The predictors of dyskinesia were determined using multivariate logistic regression analysis.
  
  
  RESULTS
  The mean age was 65.6 ± 8.5 years. The mean onset age was 58.5 ± 9.8 years. The median disease duration was 6 (7) years. Dyskinesia was present in 44% (n = 42) with median levodopa therapy of 3 years. There were 64.3% Chinese, 31% Malays, and 3.7% Indians and other ethnic groups. Eighty-one percent of patients with dyskinesia had clinical fluctuations. Patients with dyskinesia had lower onset age ( p < 0.001), longer duration of levodopa therapy ( p < 0.001), longer disease duration ( p < 0.001), higher total daily levodopa dose ( p < 0.001), and higher total UPDRS scores ( p = 0.005) than patients without dyskinesia. The three significant predictors of dyskinesia were duration of levodopa therapy, onset age, and total daily levodopa dose.
  
  
  CONCLUSIONS
  The prevalence of levodopa-induced dyskinesia in our patients was 44%. The most significant predictors were duration of levodopa therapy, total daily levodopa dose, and onset age.
authors: 1Neurology Unit, Department of Medicine, Universiti Kebangsaan Malaysia Medical Center (UKMMC) , Kuala Lumpur , Malaysia.
authors: H Z
authors: HZ
authors: Hashim
authors: M I
authors: MI
authors: Norlinah
authors: W Y
authors: WY
authors: Nafisah
authors: H J
authors: HJ
authors: Tan
authors: A A
authors: AA
authors: Raymond
authors: A M
authors: AM
authors: Tamil
mesh_terms: D000368:Aged; D000978:Antiparkinson Agents / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D004409:Dyskinesia, Drug-Induced / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology; D005260:Female; D006801:Humans; D007980:Levodopa / Q000009:adverse effects*; D008296:Malaysia / Q000453:epidemiology / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000188:drug therapy / Q000453:epidemiology / Q000208:ethnology; D011237:Predictive Value of Tests; D012307:Risk Factors; D012720:Severity of Illness Index
chemical_list: D000978:Antiparkinson Agents; D007980:Levodopa