Abstract
We investigated factors that influence prognosis in 49 patients with idiopathic Parkinson's disease (PD) . In 1992, we studied the following factors that may be associated with prognostic outcome in these patients symptoms, duration of illness, age of onset, clinical severity, medication, cerebral atrophy, and incidental cerebral hyperintensities on magnetic resonance imaging. We also assessed congnitive function in these patients. In 1996, we studied the relationship of these factors to both congnitive function and functional status in daily life in patients who could be contacted.
Higher age and Hoehn-Yahr stages and poorer performance on the“letter pick-out test”were significantly related to poorer functional status in 1996.
Second, we analyzed patients in whom dementia developed during the 4-year period. Patients who were older at onset and at the first examination in 1992 and patients with progressive motor deficits were significantly predisposed to the development of dementia during this period.
Finally, we investigated causes of death. Six patients died of pneumonia, 2 died of subarachnoid hemorrhage, and 1 each died of acute subdural hematoma and paralytic ileus.
This study reconfirmed the previous notion that high age is the primary indicator of future deterioration of both motor and cognitive functions. Additionally, the results of this study suggest that clinical severity and frontal brain dysfunction may also predict future motor, but not cognitive, deterioration and that death is usually caused by pneumonia related to parkinsonism.
