Introduction: Progressive decline in functional status is the expected natural course of Parkinson’s disease. The variability between patients, manifested by individual patients motoric function and disability seem to progress at different rates. Aim: To determine the overall rate of functional decline after 4 years in patients with Parkinson’s disease who were receiving routine treatment and to assess the factors associated with functional changes in disease progression. Methods: A comparative serial surveystudy. Of the 42 patients originally derived from a hospital-based study, 37 were re-examined after 4 years of follow-up. Information on functional status was obtained using the same scale Unified Parkinson Disease Rating Scale (UPDRS) versi 3.0, the Hoehn and Yahr staging, and the Schwab and England score, when assessed during the on state. Results: After 4 years, compared with baseline there was significant changes (all p value <0,001), of total UPDRS score increase 13,76 points, UPDRS I- mentation, behavior and mood increase 2,32 points, UPDRS II- ADL increase 4,95 points, UPDRS III- motor function increase 4,49 points, UPDRS IV-complication of treatment increase 1,97 points and Schwab and England scale decreased 6,22%. Older age, longer disease duration, first cardinal sign’s rigid-akinetic, and poor compliance were associated with greater impairment in functional scale. Conclusions: We found a functional decline of total UPDRS, each UPDRS subscale, also the the Hoehn and Yahr staging and the Schwab and England ADL scale. Overall rate of functional scale worsened significantly with time. Age,disease duration, associated with functional scale changes thought to be due to involvement of non-dopaminergic brain structures, are related to more impaired functional status.
|Publication status||Published - 2010|