Objective: 1. To analyse the outcome of Late onset Parkinson’s disease over ten year period. 2. To look for any relationship between Initial cognition to later development of Parkinson disease Dementia. 3. To ascertain relationship between development of Parkinson disease Dementia and independence. 4. To analyse the relationship between mobility and falls.

Background: There are very few study available to show the outcome of late onset Parkinson disease over a decade and relationship with falls / dementia / dependency which are major burden in Parkinson’s disease and main factors for carers strain.We wanted to see effect of routine clinical practice on outcome of these complex patients.

Methods: A Movement disorder clinic in elderly care setting have an electronic database capturing all patients activity in a local hospital in South Wales. We interrogated this data base for all patients diagnosed PD for more than 10 years and looked at their records regarding Cognition at diagnosis of PD and at ten years, mobility, tremor or axial dominance evidence of falls and its relationship with Dementia if any. We also looked at any relationship of falls with mobility.Patients needed to be 60 or over at diagnosis and at least ten years of follow up.

Results: 43 patients were identified as per inclusion criteria. 42 had complete records. 27 were male; Mean age at diagnosis was 65 yrs. Mean follow up was 149 months (12.5yrs). Third of patients were tremor dominant at diagnosis, another third were Tremor Plus axial dominant symptoms. Mean H&Y at 10 yrs + was 3.8, Almost all had normal cognition at diagnosis (41/42) as per family and patient day to day feedback. At 10 years 45% (19/42) were diagnosed as PDD and 24% developed mild to moderate cognitive impairment.Those with Dementia 74% had poor mobility and 61% with Dementia had falls by end of follow up. At final follow up all were on Levodopa and 52% had poor mobility needing assistance to walk, 31% could walk without assistance and 12% had near normal mobility. 33% needed all help and 40% needed some help while 26% were independent in PADL, 26% lived alone, 2 patient died and two were in care home. 45% of total cohort had had falls, amongst the fallers 53% had poor mobility and 42% had reasonable mobility.

Conclusions: This is real life study of late onset PD as observed in routine clinical practice. Normal cognition at diagnosis didn’t predict risk of Dementia (PDD) as almost all our patients had normal cognition. Majority (73%) of patients with Dementia needed all or some help in day to day living. Over half (53%) fallers had poor mobility although fallers also included patients with reasonable mobility. In this study mortality and care home placement was low.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/longitudinal-observational-study-on-late-onset-parkinsons-disease-over-a-decade/