Objective: This study’s primary aim was to identify the prevalence of APD in Thai PD patients using CEPA’s definition. Demographic data, some motor and non-motor symptoms apart from those mentioned items in the CDEPA questionnaire, and treatment modalities, including oral and device-aided therapies (DATs), were reported.

Background: Parkinson’s disease (PD) is divided into early, mid, and advanced stages. Identifying each stage of PD especially on advanced PD (APD) is essential because the management of APD is needed to integrate various treatment modalities to control the disease’s symptoms. Recently, there is a consensus of the definition of APD proposed by the CEPA study.

Method: A retrospective medical record review of all registered PD patients at Movement disorders clinic, Siriraj Hospital, Thailand, was done from January 2016 to January 2020. All data were collected during “ON” time.

Results: The period prevalence of APD was 37.1% (208 out of 560), with male predominance (57.7%). The mean age (SD) of APD was 65.6 (9.6) years. The median durations of the disease and motor complications were 11.9 and 5.8 years, respectively. Most APD patients were in H&Y stage 3 (57.6%). The mean (SD) score of total MDS-UPDRS and median scores (IQR) of MDS-UPDRS part III were 70.1 (22.8) points and 32.0 (25.0,42.5) points. The median axial sub-score in APD patients was 11.0 (7.0,16.0) points. APD patients who fulfilled the indication for receiving DATs were 77.9% (162 of 208). Only eighty-seven patients (53.7%) received DATs, mainly deep brain stimulation (90.8%). The primary factor that prevented the patients from DATs was socioeconomic problems (72.0%).  

Conclusion: The prevalence of APD was around one-third. Only half of APD patients who fulfilled the indication for receiving DATs could receive the treatments. These current results may raise awareness of identifying APD and may impact the process of patient care ranging from a level of individual patient care to a national APD treatment policy, which an ultimate goal is to provide proper clinical care to APD patients.

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