DISABILITY AND PROGRESSION IN PARKINSON'S DISEASE

Abstract

Disability and progression in Parkinson''s disease prior to levodopa treatment was investigated in a random group of 442 patients representing 91% of all known cases with Parkinson''s disease in a defined area. Almost half the patients were totally independent, 27% needed help occasionally and 25% were dependent on other people. Of the patients, 10% had only unilateral symptoms, 57% had bilateral involvement with mild disability, 20% had a moderately advanced disease and 13% were severely disabled. A great vaiation was found in progression rates. In individual cases the progression rate seemed relatively fixed. Concurrent arteriosclerosis worsened the prognosis. Beginning the disease with a tremor and the occurrence of prominent tremor promised a progression. Patients (26) with only unilateral symptoms 10 yr after onset of the disease were found to correspond to postencephalitic patients in age structure; in such cases a history of preceding CNS viral infection was observed on 4 occasions.