Abstract:
OBJECTIVE:To determine the risk, predictors, and prognosis of independence loss and institutionalization in patients with early Parkinson disease (PD). METHODS:We conducted a prospective population-based 5-year longitudinal study following 189 patients with incident PD and 174 controls matched for age, sex, and comorbidity. Health care status was assessed repeatedly with standardized interviews. RESULTS:More newly diagnosed patients with PD (15.9%) than controls (5.7%) were dependent in activities of daily living at baseline (relative risk [RR] 2.8, p = 0.004). During follow-up, 40.9% of the initially independent patients lost their independence vs 9.1% of controls (RR 4.5, p < 0.001). Higher age, shorter symptom duration, increasing motor severity, and presence of mild cognitive impairment at PD diagnosis independently predicted independence loss during follow-up. Dependency was irreversible in most (>95%) patients. Long-term care facility placement was needed in 8.8% of patients vs 0.6% of controls (RR 15.4, p = 0.001). More patients with PD admitted to long-term care facilities were fallers (RR 4.8, p < 0.001), had hallucinations (RR 4.4, p = 0.001), or had dementia (RR 4.2, p < 0.001) than home-dwelling patients. Once admitted to a long-term care facility, the age-adjusted RR for death during the study period was 5.5 (p = 0.002) vs patients never admitted and 25.1 (p < 0.001) vs controls. CONCLUSIONS:Patients with early PD face a substantially greater risk of independence loss and institutionalization than well-matched controls. Independence loss is irreversible in most patients and represents a sinister prognostic factor in early PD. These findings have implications for patient management and health care planning.
journal_name
Neurologyjournal_title
Neurologyauthors
Bjornestad A,Tysnes OB,Larsen JP,Alves Gdoi
10.1212/WNL.0000000000003213subject
Has Abstractpub_date
2016-10-11 00:00:00pages
1599-1606issue
15eissn
0028-3878issn
1526-632Xpii
WNL.0000000000003213journal_volume
87pub_type
杂志文章,多中心研究相关文献
NEUROLOGY文献大全abstract:OBJECTIVE:To compare effects of immediate-release (IR) and sustained-release (CR) carbidopa/levodopa in levodopa-naive PD patients. BACKGROUND:It was hypothesized that the long-acting preparation would be associated with fewer long-term complications. METHODS:A total of 618 patients were studied in 36 centers worldwi...
journal_title:Neurology
pub_type: 临床试验,杂志文章,多中心研究,随机对照试验
doi:10.1212/wnl.53.5.1012
更新日期:1999-09-22 00:00:00
abstract:OBJECTIVE:To investigate the risk factors of neutralizing antibody (NAB)-induced complete secondary treatment failure (cSTF) during long-term botulinum neurotoxin (BoNT) treatment in various neurologic indications. METHODS:This monocenter retrospective cohort study analyzed the data of 471 patients started on BoNT the...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000009444
更新日期:2020-05-19 00:00:00
abstract::While intracranial tuberculomas have become uncommon in industrial nations, 12 patients with signs and symptoms of an intracranial mass lesion were recently found to have tuberculomas. Clinical findings suggestive of tuberculosis were frequently subtle or absent. Five patients did not have extracranial tuberculosis. T...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.28.3.256
更新日期:1978-03-01 00:00:00
abstract::Lubag (X-linked dystonia-parkinsonism) has been considered a sex-linked recessive trait and has been mapped to the pericentromeric region of the X chromosome. We studied a 54-year-old man with lubag and two of his female first cousins. Genetic typing was carried out using X chromosome markers. Fluorodopa PET was perfo...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.43.8.1555
更新日期:1993-08-01 00:00:00
abstract::Pergolide, a long-acting central dopamine agonist, was used as monotherapy in 16 parkinsonian patients. A mean daily dose of 6.3 mg resulted in 73% improvement of parkinsonian disability. Clinical improvement after acute administration of one dose of pergolide was similar to that observed after levodopa plus a periphe...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.34.7.983
更新日期:1984-07-01 00:00:00
abstract::Postprandial hypotension occurs commonly in patients with autonomic failure and may be due to attenuation of the normal sympathetic nervous system activation in response to meal ingestion. In a randomized, double-blind, placebo-controlled study, we investigated the therapeutic effect of the norepinephrine precursor 3,...
journal_title:Neurology
pub_type: 临床试验,杂志文章,随机对照试验
doi:10.1212/wnl.47.6.1414
更新日期:1996-12-01 00:00:00
abstract:OBJECTIVES:Functional neuroimaging has shown that the absence of externally observable signs of consciousness and cognition in severely brain-injured patients does not necessarily indicate the true absence of such abilities. However, relative to traumatic brain injury, nontraumatic injury is known to be associated with...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0b013e318249f764
更新日期:2012-03-13 00:00:00
abstract:OBJECTIVE:To examine the association between socioeconomic status (SES) and disability outcomes and progression in multiple sclerosis (MS). METHODS:Health administrative and MS clinical data were linked for 2 cohorts of patients with MS in British Columbia (Canada) and South East Wales (UK). SES was measured at MS sym...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000007190
更新日期:2019-03-26 00:00:00
abstract:BACKGROUND AND PURPOSE:Resistance to insulin-mediated glucose uptake by peripheral tissues is a cardinal defect in type 2 diabetes mellitus. Insulin resistance is also common among nondiabetic individuals, and may be an important risk factor for stroke in both populations. The authors review the definition, epidemiolog...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.59.6.809
更新日期:2002-09-24 00:00:00
abstract:BACKGROUND:Benefit from carotid endarterectomy is greatest when performed within 2 weeks of a presenting TIA or stroke and decreases rapidly thereafter. OBJECTIVE:To determine the delays to carotid imaging and endarterectomy in Oxfordshire, UK, and the consequences for the effectiveness of stroke prevention. METHODS:...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000170368.82460.b4
更新日期:2005-08-09 00:00:00
abstract::This article presents the findings relating to the European subgroup of 91 patients in an international survey of the current diagnosis and treatment of patients with amyotrophic lateral sclerosis (ALS). The mean time between first symptoms and first consultation with a physician was 4.9 months, and mean delay in seei...
journal_title:Neurology
pub_type: 杂志文章
doi:
更新日期:1999-01-01 00:00:00
abstract::Loading doses of 15 to 20 mg per kilogram of both phenobarbital and phenytoin, administered intravenously, are necessary in the newborn to achieve rapid therapeutic plasma anticonvulsant levels. Maintenance doses of 3 to 4 mg per kilogram of both agents will maintain therapeutic levels. Phenytoin is, however, not pred...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.31.9.1107
更新日期:1981-09-01 00:00:00
abstract:OBJECTIVE:Gingival overgrowth is an important adverse effect of phenytoin (PHT) therapy, occurring in about half of the patients. This study aimed to evaluate the effect of oral folic acid supplementation (0.5 mg/day) for the prevention of PHT-induced gingival overgrowth (PIGO) in children with epilepsy aged 6-15 years...
journal_title:Neurology
pub_type: 杂志文章,随机对照试验
doi:10.1212/WNL.0b013e3182152844
更新日期:2011-04-12 00:00:00
abstract::Inclusion-body myositis (IBM) is an inflammatory muscle disease that has proven resistant to treatment. Tumor necrosis factor molecules have been detected in muscle biopsies from patients with IBM. Etanercept is a TNFalpha receptor fusion protein that binds and inactivates tumor necrosis factor. Nine patients were tre...
journal_title:Neurology
pub_type: 临床试验,杂志文章
doi:10.1212/01.wnl.0000192258.32408.54
更新日期:2006-01-24 00:00:00
abstract:OBJECTIVE:To examine neurofilament (Nf) concentrations according to symptom onset and clinical diagnostic certainty categories of amyotrophic lateral sclerosis (ALS). METHODS:We measured Nf light chain (NfL) and phosphorylated Nf heavy chain (pNfH) CSF and NfL serum levels in patients with ALS with first symptom onset...
journal_title:Neurology
pub_type: 杂志文章,多中心研究
doi:10.1212/WNL.0000000000004761
更新日期:2018-01-02 00:00:00
abstract::Thirty-eight survivors from among 117 patients hospitalized after out-of-hospital cardiac arrest were evaluated approximately 3 1/2 years later. Twenty patients were living; 18 had died. Fifty-three percent had resumed independent social activities, but only 32% had returned to work. Eight of 14 patients tested were n...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.30.12.1298
更新日期:1980-12-01 00:00:00
abstract:OBJECTIVE:Unilateral temporoparietal injury may result in an attentional deficit for stimuli presented in contralesional space. Thus, bilateral temporoparietal degeneration associated with Alzheimer disease (AD) might result in a bilateral attentional disturbance. Tests for hemispatial neglect, however, primarily asses...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000276956.65528.d4
更新日期:2007-09-11 00:00:00
abstract::Fluctuations in motor response eventually affect most patients with Parkinson's disease who have been exposed to chronic, intermittent levodopa administration for longer than 5 years. Response oscillations are often related to the timing of levodopa doses (predictable "wearing-off"), but random "on-off" effects also o...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:
更新日期:1994-07-01 00:00:00
abstract:OBJECTIVES:To evaluate the frequency, clinical and etiologic features, and short- and long-term outcomes of early recurrent TIA. METHODS:This prospective observational cohort study enrolled all consecutive patients with TIA referred to our emergency department and diagnosed by a vascular neurologist. Expedited assessm...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000010317
更新日期:2020-09-22 00:00:00
abstract:OBJECTIVE:To examine whether the incidence, comorbidity, and mortality of first-time ischemic stroke changed in Denmark between 1996 and 2016 overall and according to age and sex using a nationwide cohort design. METHODS:In this cohort study, 224,617 individuals ≥18 years of age admitted with first-time ischemic strok...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000010647
更新日期:2020-10-27 00:00:00
abstract::Restless legs syndrome (RLS) is a common neurologic disorder that affects 5 to 10% of the population and increases in prevalence with aging. The clinical hallmarks of RLS include dysesthesias or paresthesias in the legs and sometimes the arms, occurring primarily at rest, which are usually worse in the evening and are...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.58.suppl_1.s87
更新日期:2002-02-26 00:00:00
abstract::Two hypertensive men presented clinically with small, largely unilateral hematomas of the pons and midbrain demonstrated by computerized tomography. Clinical manifestations included "ocular bobbing," complex forms of ophthalmoplegia, Cheyne-Stokes respiration, and pyramidal tract signs. The "typical" sings of massive ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.30.6.652
更新日期:1980-06-01 00:00:00
abstract::Epilepsia partialis continua (EPC) may occur during nonketotic hyperglycemia but has not been described with diabetic ketoacidosis. The authors report a patient with EPC associated with ketotic hyperglycemia. Brain MRI showed two areas of abnormal signal intensity in the left precentral gyrus and in the right cerebell...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.57.3.534
更新日期:2001-08-14 00:00:00
abstract::Intravenous tissue plasminogen activator (tPA) is an effective therapy for treatment of acute ischemic stroke when administered within 3 hours of symptom onset. Three large randomized clinical trials that have attempted to extend the time window for tPA treatment beyond 3 hours have failed to demonstrate convincing ev...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/wnl.57.suppl_2.s77
更新日期:2001-01-01 00:00:00
abstract::Epilepsy is common in people with intellectual and developmental disabilities (IDD). In adulthood, patients with IDD and epilepsy (IDD-E) have neurologic, psychiatric, medical, and social challenges compounded by fragmented and limited care. With increasing neurologic disability, there is a higher frequency of epileps...
journal_title:Neurology
pub_type: 杂志文章,评审
doi:10.1212/WNL.0000000000002060
更新日期:2015-10-27 00:00:00
abstract::Kuru plaques are the pathologic hallmark in Gerstmann-Sträussler syndrome (GSS). To demonstrate that prion protein (PrP) is a component of kuru plaque cores, we fractionated and sequenced kuru plaque core derived peptides, following digestion with Achromobacter lyticus protease I. We identified 3 PrP-derived peptides ...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.41.2_part_1.306
更新日期:1991-02-01 00:00:00
abstract:BACKGROUND:Affective-motivational and sensory-discriminative aspects of pain were investigated in patients with mild to moderate Alzheimer disease (AD) and healthy elderly controls using the cold pressor test tolerance and repetitive stimuli of warmth and heat stimuli, evaluating the stimulus-response function. METHOD...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/WNL.0000000000001465
更新日期:2015-04-14 00:00:00
abstract:OBJECTIVE:To determine whether patients with Alzheimer disease (AD) compensate for neuropathologic changes when performing a mnemonic task by recruiting 1) the same brain regions as age-matched, healthy controls, but to a greater extent; 2) additional brain regions not activated by controls; or 3) both. METHODS:Twelve...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/01.wnl.0000237534.31734.1b
更新日期:2006-09-26 00:00:00
abstract::A 51-year-old man had a 4-month history of progressive headache and gradual onset of somnolence. MRI suggested spontaneous intracranial hypotension (SIH) with diencephalic compression, but he did not improve after three epidural blood patches. He became alert following intrathecal saline infusion that normalized his C...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.50.6.1854
更新日期:1998-06-01 00:00:00
abstract::Charcot-Marie-Tooth disease type 1A (CMT1A) and hereditary neuropathy with liability to pressure palsies (HNPP) are inherited peripheral neuropathies. In most cases these disorders are caused by either the duplication (in CMT1A) or the deletion (in HNPP) of a 1.5-megabase DNA fragment on chromosome 17p11.2, which cont...
journal_title:Neurology
pub_type: 杂志文章
doi:10.1212/wnl.50.3.760
更新日期:1998-03-01 00:00:00