 |
|
Prognosis of Parkinson Disease
Risk of Dementia and Mortality: The Rotterdam Study
Lonneke M. L. de Lau, MD;
C. Maarten A. Schipper, PhD;
Albert Hofman, MD, PhD;
Peter J. Koudstaal, MD, PhD;
Monique M. B. Breteler, MD, PhD
Arch Neurol. 2005;62:1265-1269.
Background Most prognostic studies on Parkinson disease have been hospital based or have applied register-based case-finding methods. Potential underrepresentation of mild cases may have given biased results.
Objective To evaluate whether Parkinson disease is associated with an increased risk of dementia and death.
Design Population-based cohort study. Parkinson disease and dementia were assessed through in-person examination at baseline (1990-1993) and 2 follow-up visits (1993-1994 and 1997-1999). Computerized linkage to medical and municipality records provided additional information on disease outcomes and mortality.
Setting General population.
Participants A total of 6969 participants, including 99 prevalent and 67 incident cases of Parkinson disease.
Main Outcome Measures Incident dementia and death. Adjusted hazard ratios were calculated through Cox proportional hazards regression analysis.
Results Patients with Parkinson disease had an increased risk of dementia (hazard ratio, 2.8; 95% confidence interval, 1.8-4.4), which was especially pronounced in participants carrying at least 1 apolipoprotein E gene (APOE)  2 allele (13.5; 4.5-40.6). Parkinson disease was associated with an increased mortality risk (1.8; 1.5-2.3). The association consistently diminished when analyses were sequentially restricted to patients with shorter disease duration and after adjustment for the occurrence of dementia.
Conclusions Especially patients with Parkinson disease who carry an APOE 2 allele have an increased risk of developing dementia. Increased mortality risk in Parkinson disease is dependent on disease duration and is only modest in the absence of dementia.
Author Affiliations: Departments of Epidemiology and Biostatistics (Drs de Lau, Schipper, Hofman, and Breteler) and Neurology (Drs de Lau and Koudstaal), Erasmus Medical Center, Rotterdam, the Netherlands.
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati  Twitter
What's this?
THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES
|
Estimating dementia-free life expectancy for Parkinson's patients using Bayesian inference and microsimulation
van den Hout and Matthews
Biostatistics 2009;10:729-743.
ABSTRACT
| FULL TEXT
APOE Alleles in Parkinson Disease and Their Relationship to Cognitive Decline: A Population-based, Longitudinal Study
Kurz et al.
J Geriatr Psychiatry Neurol 2009;22:166-170.
ABSTRACT
Parkinson Disease: Systemic and Orofacial Manifestations, Medical and Dental Management
Friedlander et al.
Journal of the American Dental Association 2009;140:658-669.
ABSTRACT
| FULL TEXT
Parkinson disease and risk of mortality: A prospective comorbidity-matched cohort study
Driver et al.
Neurology 2008;70:1423-1430.
ABSTRACT
| FULL TEXT
Dementia and survival in Parkinson disease: A 12-year population study
Buter et al.
Neurology 2008;70:1017-1022.
ABSTRACT
| FULL TEXT
Estimated life expectancy of Parkinson's patients compared with the UK population
Ishihara et al.
J. Neurol. Neurosurg. Psychiatry 2007;78:1304-1309.
ABSTRACT
| FULL TEXT
Evolution of cognitive dysfunction in an incident Parkinson's disease cohort
Williams-Gray et al.
Brain 2007;130:1787-1798.
ABSTRACT
| FULL TEXT
Subjective Complaints Precede Parkinson Disease: The Rotterdam Study
de Lau et al.
Arch Neurol 2006;63:362-365.
ABSTRACT
| FULL TEXT
|
