Session Information
Date: Tuesday, September 24, 2019
Session Title: Parkinsonisms and Parkinson-Plus
Session Time: 1:45pm-3:15pm
Location: Agora 3 West, Level 3
Objective: To determine whether non-motor symptoms predict the development of functional dependency in Parkinson’s disease (PD).
Background: Non-motor symptoms are increasingly recognized as an integral component of PD. Growing evidence has shown that earlier development of non-motor symptoms is associated with a more rapid disease progression of PD, which suggests that such symptoms may be one of the most useful markers for predicting functional dependency. However, the impact of non-motor symptoms on the development of dependency has been unclear.
Method: This study using the PPMI data included 405 patients with newly diagnosed PD without functional dependency at baseline visit. We collected baseline demographic and clinical data. Non-motor symptoms were measured using well-validated instruments covering neuropsychiatric, sleep-related, olfactory, and autonomic symptoms. The development of dependency was defined to be present if a Schwab and England score of less than 80% at any time point remained during the rest of the follow-up. Cox proportional-hazards regression analyses were performed to identify predictors of dependency.
Results: During a median follow-up of 5.0 years, 61 patients (15%) became functionally dependent. Among the non-motor variables, only the REM sleep behavior disorder (RBD) screening questionnaire (RBDSQ) score was associated with the development of dependency (hazard ratio [HR] 1.20; 95% confidence interval [CI] 1.10–1.30; p=0.016). Furthermore, the bradykinesia subscore was also a significant predictor of dependency (HR 1.05; 95% CI 1.00–1.09; p=0.043). The RBDSQ score was further inserted as a dichotomous variable in the multivariable Cox model. When using a cut-off score of 5, the presence of RBD was predictive of dependency (HR 2.16; 95% CI 1.24–3.75; p=0.006). This significant association also persisted when using a cut-off score of 6 (HR 1.79; 95% CI 1.02–3.13; p=0.043).
Conclusion: The presence of RBD in patients with early PD was associated with an increased risk of functional dependency. This finding supports the notion that RBD portends poor prognosis in PD.
To cite this abstract in AMA style:
R. Kim, D. Yoo, JH. Im, HJ. Kim, B. Jeon. Non-motor symptoms and risk of functional dependency in early Parkinson’s disease [abstract]. Mov Disord. 2019; 34 (suppl 2). https://www.mdsabstracts.org/abstract/non-motor-symptoms-and-risk-of-functional-dependency-in-early-parkinsons-disease/. Accessed September 7, 2024.« Back to 2019 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/non-motor-symptoms-and-risk-of-functional-dependency-in-early-parkinsons-disease/