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Changes in quality of life in people with Parkinson’s disease left untreated at diagnosis
  1. Panagiotis Asimakopoulos (achaean7{at}googlemail.com)
  1. Crosshouse Hospital, Kilmarnock, United Kingdom
    1. Robert Caslake (bob.caslake{at}abdn.ac.uk)
    1. University of Aberdeen, United Kingdom
      1. Clare E Harris (c.harris{at}abdn.ac.uk)
      1. University of Aberdeen, United Kingdom
        1. Joanna C Gordon (j.c.gordon{at}abdn.ac.uk)
        1. University of Aberdeen, United Kingdom
          1. Kate SM Taylor (katetaylor2{at}nhs.net)
          1. Institute of Neurological Sciences, Southern General Hospital, Glasgow, United Kingdom
            1. Carl Counsell (carl.counsell{at}abdn.ac.uk)
            1. University of Aberdeen, United Kingdom

              Abstract

              Background:The issue of whether to adopt a “wait and watch” strategy or to initiate drug therapy soon after diagnosis in Parkinson’s disease (PD) has been the subject of some debate. A recent observational study supported early treatment by demonstrating deterioration in self reported health status in those left untreated, but not those who received therapy. We aimed to replicate this observation.

              Methods:People with PD from a prospective incidence study underwent follow-up with yearly clinical assessment of parkinsonian impairment (UPDRS) and self reported health status (PDQ-39). Two year outcomes were compared in those who started treatment within one year of diagnosis and those left untreated.

              Results:42 patients with PD were followed up for two years, of whom 26 started treatment during the first year and 16 remained untreated. Those receiving treatment had significantly higher UPDRS and PDQ-39 scores at baseline. There was no significant deterioration in PDQ-39 score in either group (median change untreated 0.8 vs treated 4.0, p=0.47), despite a significant difference in the change of motor UPDRS scores (untreated 6.0 vs treated -6.0, p=0.03).

              Conclusion:Given the lack of significant deterioration in the PDQ-39 in untreated patients, we believe a “wait and watch” strategy for the treatment of newly diagnosed PD remains a credible approach unless randomised trials prove otherwise.

              • Antiparkinson agents
              • Disease progression
              • Follow-up studies
              • Health status
              • Parkinson disease

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