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EFFECTS OF VASCULAR COMORBIDITY IN PARKINSON'S DISEASE
  1. Diane M A Swallow1,
  2. Naveed Malek1,
  3. Katherine A Grosset1,
  4. Michael A Lawton1,
  5. Nin P Bajaj1,
  6. Roger A Barker2,
  7. Yoav Ben-Shlomo5,
  8. David J Burn3,
  9. Huw R Morris4,
  10. Nigel Williams1,
  11. Nicholas W Wood1,
  12. Donald G Grosset1,
  13. on behalf of the PRoBaND collaborators1
  1. 1Queen Elizabeth University Hospital, Glasgow
  2. 2School of Social and Community Medicine, University of Bristol
  3. 3Queen's Medical Centre, Nottingham
  4. 4John van Geest Centre for Brain Repair, Cambridge
  5. 5University of Newcastle

Abstract

Vascular disease and risk factors are common in Parkinson's disease (PD) and may influence phenotype. Statin therapy may thus be indicated. 1759 recently diagnosed PD cases from a multicentre prospective study underwent a Montreal Cognitive Assessment and the Unified PD Rating Scale part 3 (UPDRS 3). History of vascular events, risk factors and statin usage was recorded. QRISK2 quantified cardiovascular risk. Mean age was 67.5 (SD 9.3), disease duration 1.3 (SD 0.9) years, 65.2% male. 4.7% had prior stroke/TIA, 12.5% cardiac disease, 30.4% hypertension, 27.3% high cholesterol, 20.7% obesity, 7.2% diabetes and 4.6% smokers. Patients with prior stroke/TIA had more cognitive impairment (42.0% versus 25.0%, p<0.001) and postural instability gait difficulty (p=0.02). 32.6% had QRISK2 ≥20%, 30.2% QRISK2 10–20%, and 22.5% QRISK2 <10%. Age (p<0.001), sex (p<0.001), UPDRS 3 (p<0.001) and cognitive impairment (p=0.019) differences were significant across groups; higher QRISK2 patients were therefore older with worse motor and cognitive status. 77.4% of vascular disease cases were prescribed statins, compared to 37.3% for QRISK2 ≥20%. Vascular comorbidity contributes to disease pattern in PD, and statin usage is suboptimal. This has prognostic and treatment implications.

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