Parkinson's Disease Tulip


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Old 07-21-2013, 11:48 PM #1
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Default Not good news

http://www.newsfix.ca/2013/07/20/par...-and-dementia/
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Old 07-22-2013, 12:15 AM #2
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The link states:

"Researchers from the Central Hospital of Rogaland in Stavanger, Norway, found that nearly 80% of the Parkinson’s patients they studied over an eight-year period developed dementia. ... In the study, 224 Parkinson’s patients were interviewed. ... Patients were evaluated for dementia at their initial examination and four and eight years later. At the beginning of the study, 51 patients with PD had dementia. A total of 43 and 28 new cases of dementia were identified after four and eight years of follow-up, respectively."

Where does the 80% come from?

I make it (51 + 43 + 28)/224 = 54.5%

Still not good news, but better.

John
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Old 07-22-2013, 01:35 AM #3
Bogusia Bogusia is offline
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As per article posted on the Northwest Parkinson's Foundation website one of the best way to prevent PD dementia is to increase social interaction.
For me, right now, it requires effort to go out, or "interact" (tired, medication issues, tremor, etc) and I am only in the beginning of PD journey. Once I force myself to go out I feel better afterwords but it doesn't make it easier when I have an opportunity to do it again. Also, I live in a town where there are limited resources for PD patients. When I tried to sign up with local Parkinson organization I was told that they are full but I could be placed on the waiting list. I am thankful for interactions on this forum, no waiting list here.

http://www.nwpf.org/news.aspx?item=3721
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Old 07-22-2013, 01:58 AM #4
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Bogusia,

You're right, social interaction is very important.

This forum is great, but it can't replace face-to-face interactions.

What sort of Parkinson's organization is full?

My advice is to join a club with a good social life (in my case crown green bowling). The rest will follow.

John
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Current meds: Stalevo(75 mg) x 5, ropinirole xl 8 mg, rasagiline 1 mg
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Old 07-22-2013, 06:58 AM #5
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Quote:
Originally Posted by johnt View Post
The link states:

"Researchers from the Central Hospital of Rogaland in Stavanger, Norway, found that nearly 80% of the Parkinson’s patients they studied over an eight-year period developed dementia. ... Where does the 80% come from?

I make it (51 + 43 + 28)/224 = 54.5%

John
Good question, John. This is actually a fairly old study (2003) and the article didn't give full detail. There were 55 deaths and 10 drop-outs. So, they used a baseline sample of 159, not 224.

Gary
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Old 07-22-2013, 07:06 AM #6
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Slightly puzzling, probably from lack of full study information. At "initial examination" presumably means on entry into trial? And 51 participants had dementia? But no measure of dementia actually given? Or average duration since diagnosis of those with dementia? I am not so interested in those who became demented during the course of the study, because unless you know what start point was established, and how variable the participants were, then how do you glean anything from the results. For instance was this an elderly cohort, were they studied because they were already in care facilities (I have seen a lot of studies like that), or were they a more random sampling?

It is not just the figures that look a little odd, but there is no mention of what criteria is used to define dementia. Hallucinations are mentioned, and these can equally happen because of medication side effects as they can as an intrinsic part of Parkinson Disease. On their own I am not sure they are a measure of dementia. People with schizophrenia for instance have hallucinations but are not regarded as having dementia.

While this is a serious factor for PwP, I would like to know more detail of such studies than the bare bones, 'scarey', % basis on which this one is discussed.
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Old 07-22-2013, 07:10 AM #7
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Link to the abstract:

http://www.ncbi.nlm.nih.gov/pubmed/12633150
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Old 07-22-2013, 08:20 AM #8
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Quote:
Originally Posted by Bogusia View Post
As per article posted on the Northwest Parkinson's Foundation website one of the best way to prevent PD dementia is to increase social interaction.
For me, right now, it requires effort to go out, or "interact" (tired, medication issues, tremor, etc) and I am only in the beginning of PD journey. Once I force myself to go out I feel better afterwords but it doesn't make it easier when I have an opportunity to do it again. Also, I live in a town where there are limited resources for PD patients. When I tried to sign up with local Parkinson organization I was told that they are full but I could be placed on the waiting list. I am thankful for interactions on this forum, no waiting list here.

http://www.nwpf.org/news.aspx?item=3721

Bogusia, it’s truly unfortunate that a PD group would place anyone on a waiting list.

Perhaps another organization would welcome you, such as a senior center or hospital exercise, yoga or tai chi program. Maybe your senior center or public library could help form a support group for PD and other movement disorders.

My husband and I attend a weekly Dance for PD class where people with other medical conditions are welcome.

Being in an early stage of PD and having limited energy, it’s also difficult for me to find the right balance of activity and rest. It is hard to muster the energy to get out and be active but it does produce positive results.

Don’t give up Bogusia, you will find something!

Best of luck,
Stand Tall
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Old 07-22-2013, 11:14 PM #9
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Quote:
Originally Posted by johnt View Post
The link states:

"Researchers from the Central Hospital of Rogaland in Stavanger, Norway, found that nearly 80% of the Parkinson’s patients they studied over an eight-year period developed dementia. ... In the study, 224 Parkinson’s patients were interviewed. ... Patients were evaluated for dementia at their initial examination and four and eight years later. At the beginning of the study, 51 patients with PD had dementia. A total of 43 and 28 new cases of dementia were identified after four and eight years of follow-up, respectively."

Where does the 80% come from?

I make it (51 + 43 + 28)/224 = 54.5%

Still not good news, but better.

John

Wouldn't make more sense to adjust the findings factoring in age ?
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Old 07-30-2013, 07:21 AM #10
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Yes, we need to factor in age. But who has the data? Otherwise we need to adopt an indirect approach.

Lethbridge et al. looked at death certificates issued in Nova Scotia.

For PwP the main co-morbidities were:
Alzheimer's/dementia at 26.2%
Pneumonia, 22.3%
Stroke, 14.2%

Does this disprove the 80% figure after 8 years? Not quite. First, we have the issue of under-reporting: there may be a reluctance to report dementia. Second, we don't know what proportion of the people had had PD for at least 8 years before dying. A clue to this is given by Isihara et al. who report [2] "a Dutch study, ... median survival after PD diagnosis at 71 years or older was 9 years".

At this stage I get stuck. Can anyone progress this?

References

[1] Prog Palliat Care. 2013 July; 21(3): 140–145. .
doi: 10.1179/1743291X12Y.0000000037
PMCID: PMC3703207
"Co-morbidities of persons dying of Parkinson's disease"
Lynn Lethbridge, Grace M Johnston, and George Turnbull
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3703207/

[2] J Neurol Neurosurg Psychiatry 2007;78:1304-1309 doi:10.1136/jnnp.2006.100107
"Estimated life expectancy of Parkinson’s patients compared with the UK population"
Lianna S Ishihara, Anne Cheesbrough, Carol Brayne1, Anette Schrag
http://jnnp.bmj.com/content/78/12/1304.full

John
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Current meds: Stalevo(75 mg) x 5, ropinirole xl 8 mg, rasagiline 1 mg
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