Demographic and motor features associated with the occurrence of neuropsychiatric and sleep complications of Parkinson's disease
- Renato Puppi Munhoz1,2,
- Hélio A Teive1,
- Hariklia Eleftherohorinou3,
- Lachlan J Coin3,
- Andrew J Lees4,
- Laura Silveira-Moriyama4,5
- 1Department of Neurology, Hospital de Clínicas, Federal University of Paraná, Curitiba, Brazil
- 2Associacao Paranaense dos Portadores de Parkinsonismo, Curitiba, Brazil
- 3Department of Epidemiology and Public Health, Centre for Biostatistics, Imperial College St Mary's Campus, London, UK
- 4Reta Lila Weston Institute, UCL Institute of Neurology, London, UK
- 5Department of Neurology, FCM, University of Campinas, Campinas, UNICAMP, Brazil
- Correspondence to Dr Laura Silveira-Moriyama, Reta Lila Weston Institute of Neurological Studies, UCL Institute of Neurology, London WC1N 1PJ, UK;
- Received 25 October 2012
- Revised 7 February 2013
- Accepted 12 February 2013
- Published Online First 5 March 2013
Objective To determine whether four key neuropsychiatric and sleep related features associated with Parkinson's disease (PD) are associated with the motor handicap and demographic data.
Background The growing number of recognised non-motor features of PD makes routine screening of all these symptoms impractical. Here, we investigated the hypothesis that standard demographic data and the routine assessment of motor signs is associated with the presence of dementia, psychosis, clinically probable rapid eye movement (REM) sleep behavior disorder (cpRBD) and restless legs syndrome (RLS).
Methods 775 patients with PD underwent standardised assessment of motor features and the presence of dementia, psychosis, cpRBD and RLS. A stepwise feature elimination procedure with fitted logistic regression models was applied to identify which/if any combination of demographic and motor factors is associated with each of the four studied non-motor features. A within-study out-of-sample estimate of the power of the predicted values of the models was calculated using standard evaluation procedures.
Results Age and Hoehn&Yahr (H&Y) stage were strongly associated with the presence of dementia (p value<0.001 for both factors in the final selected model) while a combination of age, disease duration, H&Y stage, dopamine agonists and catechol-O-methyltransferase (COMT) inhibitors was associated with the presence of psychosis. Disease duration and H&Y stage were the significant indicators of cpRBD, and the lack of significant motor asymmetry was the only significant feature associated with RLS-type symptoms but the evidence of association was weak.
Conclusions Demographic and motor features routinely collected in patients with PD can estimate the occurrence of neuropsychiatric and sleep-related features of PD.