Abstract
The early and accurate diagnosis of Parkinson’s disease (PD) is the first step towards optimal patient management. The aim of this study was to investigate the major determinants of delayed diagnosis in PD. We recruited a population-representative cohort of 239 newly-diagnosed PD patients who underwent clinical and neuropsychological evaluation. Non-parametric methods were used to define the factors associated with diagnostic delay. The median time from motor symptom onset to primary care physician (PCP) presentation was considerably longer than the time from PCP presentation to PD diagnosis (11 vs. 1 months). Male sex and presenting motor phenotype were independently associated with delayed PCP presentation on Cox regression analysis. Patients presenting with gait disturbance experienced the longest delay, whilst those presenting with tremor had the shortest. In summary, male sex and presenting motor phenotype are key determinants of delayed diagnosis in PD.
Similar content being viewed by others
References
Goldberg D (1995) Epidemiology of mental disorders in primary care settings. Epidemiol Rev 17:182–190
Gibb WR, Lees AJ (1988) The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 51:745–752
Marrie RA, Horwitz R, Cutter G, Tyry T, Campagnolo D, Vollmer T (2009) Comorbidity delays diagnosis and increases disability at diagnosis in MS. Neurology 72:117–124
Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE (2010) Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord 25:2649–2653
Datamonitor. 2007. Current techniques and challenges
Saunders-Pullman R, Wang C, Stanley K, Bressman SB (2011) Diagnosis and referral delay in women with Parkinson’s disease. Gend Med 8:209–217
Haaxma CA, Bloem BR, Borm GF, Oyen WJ, Leenders KL, Eshuis S, Booij J, Dluzen DE, Horstink MW (2007) Gender differences in Parkinson’s disease. J Neurol Neurosurg Psychiatry 78:819–824
Banks I (2001) No man’s land: men, illness, and the NHS. BMJ 323:1058–1060
Office of Population Censuses and Surveys (1991) General Household Survey
O’Sullivan SS, Williams DR, Gallagher DA, Massey LA, Silveira-Moriyama L, Lees AJ (2008) Nonmotor sympoms as presenting complaints in Parkinson’s disease: a clinicopathological study. Mov Disord 23:101–106
Acknowledgments
This work was supported by a NIHR Biomedical Research Award to Addenbrooke’s Hospital/University of Cambridge, as well as grants from Parkinson’s UK, Cure Parkinson’s Trust and the Van Geest Foundation. DPB and JRE have been recipients of a Raymond and Beverly Sackler studentship.
Conflicts of interest
The authors declare that they have no conflicts of interest.
Author information
Authors and Affiliations
Corresponding author
Electronic supplementary material
Below is the link to the electronic supplementary material.
Rights and permissions
About this article
Cite this article
Breen, D.P., Evans, J.R., Farrell, K. et al. Determinants of delayed diagnosis in Parkinson’s disease. J Neurol 260, 1978–1981 (2013). https://doi.org/10.1007/s00415-013-6905-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00415-013-6905-3