Læknablaðið : fylgirit - 01.03.1983, Síða 254

54
A SURVEY OF PARKINSON’S DISEASE
IN GERIATRIC MEDICINE
Ársæll Jónsson, M. R. P. Hall
Introduction
Parkinson's disease is a well known clinical disorder of middle age
with rising incidence into old age (1-2).
With the advent of modern therapy the excess mortality rate of the
disease has been reduced but at the same time new problems have
arisen in connection with prolonged drug therapy and increase in
age. In this survey we describe the clinical pattern of elderly
Parkinsonian patients referred to hospital based Geriatric Services
from a total population of 65000 elderly.
Methods
A prospective survey over six months of a patients suffering from
Parkinsons disease is described. The patients were either attending
or had been referred to the geriatric services under the care of
four different consultant physicians.
The diagnosis of Parkinsons disease was made on clinical grounds by
symptoms of tremor, rigidity, bradykinesia and by a favourable
response to specific drug treatment. A physical examination was
carried out on each patient and a prepared questionaire on side
effects of drug treatment, a modified RCP Mental Test score (3-4)
and the Barthel disability Index (5) score was completed. The
hospital records were reviewed for further details of Parkinson's
disease and for other morbidity. Current drug therapy with dosage
was also recorded.
Results
Included were 4 3 patients, 14 males and 29 females. Eighteen
patients were seen in geriatric out-patient clinics, 13 during
admission to a short rehabilitation and assessment wards, 3 in
continuing care wards for holiday relief, 8 during attendence to
a day hospital and one seen at home in a domiciliary visit.
The age ranged from 65 to 89 years (mean 77.8 year). The mean time
from first referral to geriatric medicine was 2.2 years(range 1-12
years).
The mean age at onset of Parkinsons symptoms was 71.6 years (range
48-88 years) for all patients. The 20 patients who could be
regarded as classical type had a mean age at onset 68.1 year. The
larger group of 24 patients had a mean age at onset 74.2 years.
This latter group contained 6 patients who had history's of erlier
"stokes" and 3 of dementia. Three patients had drug induced
Parkinsonism with a mean age at onset 62.5 years.
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