Changes in quality of life in people with Parkinson's disease left untreated at diagnosis

P. Asimakopoulos, Robert Caslake, Clare Elizabeth Harris, Joanna Clodagh Gordon, Kate Sophia Mary Taylor, Carl Edward Counsell

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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 (Unified Parkinson's Disease Rating Scale (UPDRS)) and self-reported health status (Parkinson's Disease Questionnaire (PDQ-39)). Two year outcomes were compared with those who started treatment within 1 year of diagnosis and those left untreated.

RESULTS: 42 patients with PD were followed-up for 2 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 in 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.

Original languageEnglish
Pages (from-to)716-718
Number of pages3
JournalJournal of Neurology, Neurosurgery & Psychiatry
Volume79
Issue number6
Early online date25 Jan 2008
DOIs
Publication statusPublished - Jun 2008

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Parkinson Disease
Quality of Life
Health Status
Therapeutics
Observational Studies
Cohort Studies
Prospective Studies
Drug Therapy
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Changes in quality of life in people with Parkinson's disease left untreated at diagnosis. / Asimakopoulos, P.; Caslake, Robert; Harris, Clare Elizabeth; Gordon, Joanna Clodagh; Taylor, Kate Sophia Mary; Counsell, Carl Edward.

In: Journal of Neurology, Neurosurgery & Psychiatry, Vol. 79, No. 6, 06.2008, p. 716-718.

Research output: Contribution to journalArticle

Asimakopoulos, P. ; Caslake, Robert ; Harris, Clare Elizabeth ; Gordon, Joanna Clodagh ; Taylor, Kate Sophia Mary ; Counsell, Carl Edward. / Changes in quality of life in people with Parkinson's disease left untreated at diagnosis. In: Journal of Neurology, Neurosurgery & Psychiatry. 2008 ; Vol. 79, No. 6. pp. 716-718.
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