Sydney multicenter study of Parkinson's disease: Non-L-dopa–responsive problems dominate at 15 years

摘要: One-third of the 149 people recruited 15 to 18 years ago in Sydney Multicenter Study Parkinson's disease have survived. The original study compared low-dose levodopa with bromocriptine. We now report problems experienced by who survive from diagnosis. standardized mortality ratio is significantly elevated at 1.86 and not different between treatment arms. Falls occur 81% patients, 23% sustained fractures. Cognitive decline present 84%, 48% fulfill criteria for dementia. Hallucinations depression are 50%. Choking has occurred 50%, symptomatic postural hypotension 35%, urinary incontinence 41%. No patient still employed, 40% patients live aged care facilities. Although approximately 95% L-dopa-induced dyskinesia/dystonia end dose failure medication, majority, these symptoms disabling. Dyskinesia dystonia were delayed early use bromocriptine, but end-of-dose appeared a similar time once L-dopa was added. rate progression both arms study. conclude that most disabling long-term relate emergence improved L-dopa. Neuroprotective interventions should be judged their ability improve non-L-dopa-responsive aspects disease, rather than just capacity delay introduction or reduce its associated side effects.