Joined: Fri Aug 11, 2006 1:46 pm
Location: SF Bay Area (Northern CA)
Australian PD study: "inevitability of dementia"
Big number here: "Dementia is present in 83% of 20-year survivors [of PD]." This number is from an Australian study published in April '08. (The abstract just popped up on PubMed.) So this is the number of those who get Parkinson's Disease Dementia (PDD), which is a Lewy Body Dementia.
I think that's the largest number I've seen.
I took these notes when Dr. Ron Pfeiffer, a neurologist at the Univ of TN, spoke a couple of years ago about dementia in PD: The percentage of those with PD who have dementia increases over time: 16-21% in 5 years, and 37% in 10 years. On average, 20-30% of those with PD have dementia to some degree. In using the word "dementia," Dr. Pfeiffer is referring to these symptoms: impaired memory, especially âshort-term," impaired âretrievalâ of information, impaired problem solving, reduced initiative and motivation, and difficulty dividing and shifting attention. AD medication can be beneficial.
Dr. Bruce Miller, a neurologist at UCSF, gave this data in June '08 at a dementia conference: 10% PD develop dementia over 3.5 years, 57% showed signs of cognitive impairment (largely executive control). (The source he cited is Williams-Gray et al, 2007.)
And the LBDA says: "Over 50% of Parkinsonâs disease patients develop 'Parkinsonâs disease dementia' (PDD), which accounts for at least 750,000 patients."
So here's the abstract of the research with the 83% figure...
Movement Disorders. 2008 Apr 30;23(6):837-44.
The Sydney multicenter study of Parkinson's disease: the inevitability of dementia at 20 years.
Hely MA, Reid WG, Adena MA, Halliday GM, Morris JG.
Department of Neurology, Westmead Hospital, Westmead, New South Wales, Australia.
After 20 years follow-up of newly diagnosed patients with Parkinson's disease (PD), 100 of 136 (74%) have died. The mortality rate fell in the first 3 years of treatment, then rose compared to the general population, the standardized mortality ratio from 15 to 20 years reaching 3.1. Drug induced dyskinesia and end of dose failure were experienced by most patients, but the main current problems relate to the non-levodopa responsive features of the disease.
Dementia is present in 83% of 20-year survivors. Dementia correlates with increasing age and probably reflects an interplay of multiple pathologies. Seventeen people with dementia had postmortems. Eight had diffuse Lewy bodies as the only cause of dementia, while others had mixed neuropathology.
Only one person lives independently and 48% are in nursing homes. Excessive daytime sleepiness is noted in 70%, falls have occurred in 87%, freezing in 81%, fractures in 35%, symptomatic postural hypotension in 48%, urinary incontinence in 71%, moderate dysarthria in 81%, choking in 48%, and hallucinations in 74%. The challenge is to understand the cellular mechanisms underlying the diverse features of advanced PD that go far beyond a lack of dopamine.
PubMed ID#: 18307261 (see pubmed.gov for abstract only)