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Population-based Studies on the Clinical Progression of Parkinson’s Disease
developing PD and related neurodegenerative disorders, and thus progress into dementia, which approximately 80% of PD subjects
RBD is considered as an early sign of an evolving synucleinopathy.
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In develop during the course of their disease. Population-based studies
a population-based study of prevalent PD cases that were followed indicate rather high frequencies of other non-motor symptoms in
prospectively over eight years, prevalence of clinically probable RBD moderate to advanced stages, such as depression, fatigue, apathy,
varied with time, affecting 15–27% of subjects, and was independently sleep disorders and autonomic dysfunction, although prevalence
associated with male gender, lower disease severity and higher daily rates often are lower than those observed in clinic-based studies.
levodopa-equivalent doses.
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However, as several population-based studies were cross-sectional
and uncontrolled and did not use currently accepted rating scales or
Dysautonomia diagnostic criteria, the relative risk and clinical course of many
There are very few representative studies on autonomic dysfunction disease-related features remain unclear in the general PD population.
in PD. In a cross-sectional community-based survey of prevalent PD Hence, there is need for further population-based studies to extend
patients, 47% met criteria of orthostatic hypotension,
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and in a current knowledge on the clinical course of PD. Prospective
community-based longitudinal study of patients with six years of longitudinal case-control studies in representative incident PD
disease duration at baseline the prevalence of self-reported bladder cohorts appear the gold standard for this purpose. n
problems increased from 11 to 40% during a four-year period.
9
Impulse Control Disorders
Guido Alves is a Senior Researcher at the Norwegian
Centre for Movement Disorders, where he focuses on
There is increasing awareness that impulse control disorders, such as epidemiological and translational research in
compulsive gambling, buying, eating and hypersexuality may
Parkinson’s disease and related disorders, and a
Consultant in the Department of Neurology at
complicate the course of PD.
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However, longitudinal data from
Stavanger University Hospital in Norway. He is a
population-based cohorts on this issue remain to be published. member of the Movement Disorders Society and the
Norwegian Medical Association. Dr Alves received his
Summary
medical doctorial degree from the Ruhr-University
Bochum in Germany and his PhD from the University
Population-based data suggest that the motor course in PD is of Bergen.
generally slowly progressive, with average annual progression rates of
Jan Petter Larsen is Managing Director of the Stavanger
3% or less. However, there is a considerable inter-individual variation
University Hospital and a Professor of Neurology at
in motor decline, with more rapid progression in older subjects and
the University of Bergen. He is also Director of Research
possibly in early stages of the disease. The clinical phenotype of PD
at the Norwegian Centre for Movement Disorders and
Chairman of the Norwegian Basal Ganglia club. He has
tends to change during the course of the disease, and after 17 years
published more than 140 scientific papers with
of disease duration about 90% have developed predominant gait and
emphasis on non-motor problems in patients with
postural impairment. Twenty to 40% of patients with newly diagnosed
Parkinson’s disease.
PD show cognitive deficits. These usually worsen over time and
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