Publication
Dysphagia predicts poor outcome in late-stage Parkinson's disease
| dc.contributor.author | Fabbri, Margherita | |
| dc.contributor.author | Coelho, Miguel | |
| dc.contributor.author | Abreu, Daisy | |
| dc.contributor.author | Guedes, Leonor Correia | |
| dc.contributor.author | Rosa, Mario M. | |
| dc.contributor.author | Godinho, Catarina | |
| dc.contributor.author | Cardoso, Rita | |
| dc.contributor.author | Guimarães, Isabel | |
| dc.contributor.author | Antonini, Angelo | |
| dc.contributor.author | Zibetti, Maurizio | |
| dc.contributor.author | Lopiano, Leonardo | |
| dc.contributor.author | Ferreira, Joaquim J. | |
| dc.date.accessioned | 2019-10-21T07:42:55Z | |
| dc.date.available | 2020-08-31T00:30:15Z | |
| dc.date.issued | 2019-07 | |
| dc.description | Article under a CC-BY-NC-ND license. | pt_PT |
| dc.description.abstract | "BACKGROUND: Few data exist on the rate of clinical progression for Parkinson's disease (PD) patients who have entered a late stage of the disease. OBJECTIVE: Study the clinical progression of a late-stage PD (LSPD) population over one year follow-up. METHODS: 50 LSPD patients (Schwab and England ADL Scale <50 or Hoehn Yahr Stage >3 in MED ON) underwent an extensive clinical assessment at baseline and after one year and an acute levodopa test at baseline. RESULTS: Mean age of LSPD patients (female 46%) was 77.5 ± 5.9 years and mean disease duration was 15.5 ± 6.5 years. At baseline, 76% had levodopa-induced motor complications (MC), usually non-troublesome, 68% were demented, 54% had psychosis and 68% depression. Caregiver distress was high. l-dopa responsiveness was mild (18% ± 12 of improvement on MDS-UPDRS-III). After one-year, 20% of the patients were dead, institutionalized or HY 5. MDS-UPDRS-motor mean score worsened 7.2 ± 10.3 points although there was heterogeneity between patients, and there was a global worsening of non-motor symptoms, mostly in cognition/mood, urinary and gastrointestinal domains. Nevertheless, MC improved despite similar levodopa equivalent dose. Functional independence and quality of life worsened. Dysphagia severity at baseline predicted a poor outcome (death, institutionalization or HY 5) (Hazard ratio 2.3, 95% CI 1.12-4.4; p = 0.01), whereas magnitude of l-dopa response of LSPD patients did not. CONCLUSIONS: LSPD patients still present a significant, although heterogeneous, motor and non-motor progression over 1 year. Dysphagia severity predicts the occurrence of additional disease severity milestones and its management must be prioritized." | pt_PT |
| dc.description.version | info:eu-repo/semantics/acceptedVersion | pt_PT |
| dc.identifier.citation | Fabbri M, Coelho M, Abreu D, Guedes LC, Rosa MM, Godinho C, Cardoso R, Guimaraes I, Antonini A, Zibetti M, Lopiano L, Ferreira JJ, Dysphagia predicts poor outcome in late- stage Parkinson's disease, Parkinsonism and Related Disorders (2019), doi: https://doi.org/10.1016/j.parkreldis.2019.02.043 | pt_PT |
| dc.identifier.doi | 10.1016/ j.parkreldis.2019.02.043 | pt_PT |
| dc.identifier.issn | 1353-8020 | |
| dc.identifier.uri | http://hdl.handle.net/10400.26/29986 | |
| dc.language.iso | eng | pt_PT |
| dc.peerreviewed | yes | pt_PT |
| dc.publisher | Elsevier | pt_PT |
| dc.relation.publisherversion | https://doi.org/10.1016/j.parkreldis.2019.02.043 | pt_PT |
| dc.subject | Dementia | pt_PT |
| dc.subject | Dysphagia | pt_PT |
| dc.subject | Late stage | pt_PT |
| dc.subject | Mortality | pt_PT |
| dc.subject | Parkinson's disease | pt_PT |
| dc.title | Dysphagia predicts poor outcome in late-stage Parkinson's disease | pt_PT |
| dc.type | journal article | |
| dspace.entity.type | Publication | |
| oaire.citation.endPage | 81 | pt_PT |
| oaire.citation.startPage | 73 | pt_PT |
| oaire.citation.title | Parkinsonism and Related Disorders | pt_PT |
| oaire.citation.volume | 64 | pt_PT |
| rcaap.embargofct | Política de copyright da editora. | pt_PT |
| rcaap.rights | openAccess | pt_PT |
| rcaap.type | article | pt_PT |