Editorial commentary
The Sydney multicentre study of Parkinson's disease
| The first 150 words of the full text of this article appear below. |
Natural
history studies of Parkinson's disease with adequate duration of
follow up are scarce and fraught with difficulty due to selection bias
and retrospective assessment in hospital series, confounding effects of
comorbidity and problems of diagnostic accuracy.1 The
pivotal study by Hoehn and Yahr2 on a cohort of 672 patients with "primary parkinsonism" came up with a rather bleak
prognosis, with 61% of patients severely disabled or dead after 5 to 9 years of follow up, increasing to more than 80% of those who were
followed up for more than 10 years. Overall mortality was increased to
about threefold the expected rate in the general population. Such poor
longterm outcome is thought to reflect the history of idiopathic
Parkinson's disease in the prelevodopa era with some added negative
bias due to less stringent diagnostic criteria used in those days.
Early postlevodopa mortality studies in Parkinson's disease indeed
found mortality ratios of 1.5 or less, rising
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- The Sydney multicentre study of Parkinson's disease: progression and mortality at 10 years
- Mariese A Hely, John G L Morris, Robert Traficante, Wayne G J Reid, Dudley J O'Sullivan, and Peter M Williamson
J. Neurol. Neurosurg. Psychiatry 1999 67: 300-307.[Abstract] [Full Text] [PDF]
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