Impact of age at onset on symptom profiles, treatment characteristics and health-related quality of life in Parkinson's disease.
Lars Lau Raket, Daniel Oudin ��str��m, Jenny M Norlin, Klas Kellerborg, Pablo Martinez-Martin, Per Odin
Author Information
Lars Lau Raket: H. Lundbeck A/S, Valby, Denmark.
Daniel Oudin ��str��m: H. Lundbeck A/S, Valby, Denmark.
Jenny M Norlin: The Swedish Institute for Health Economics, Lund, Sweden.
Klas Kellerborg: The Swedish Institute for Health Economics, Lund, Sweden.
Pablo Martinez-Martin: Center of Networked Biomedical Research in Neurodegenerative Diseases (CIBERNED), Carlos III Institute of Health, Madrid, Spain.
Per Odin: Division of Neurology, Department of Clinical Sciences, Lund University, Lund, Sweden. per.odin@med.lu.se.
Parkinson's disease (PD) is typically considered an age-related disease, but the age at disease onset can vary by decades between patients. Aging and aging-associated diseases can affect the movement system independently of PD, and advanced age has previously been proposed to be associated with a more severe PD phenotype with accelerated progression. In this work, we investigated how interactions between PD progression and aging affect a wide range of outcomes related to PD motor and nonmotor symptoms as well as Health Related Quality of Life (HRQoL) and treatment characteristics. This population-based cohort study is based on 1436 PD patients from southern Sweden followed longitudinally for up to approximately 7.5 years from enrollment (3470 visits covering 2285 patient years, average follow-up time 1.7 years). Higher age at onset was generally associated with faster progression of motor symptoms, with a notable exception of dyskinesia and other levodopa-associated motor fluctuations that had less severe trajectories for patients with higher age at onset. Mixed results were observed for emergence of non-motor symptoms, while higher age at onset was generally associated with worse HRQoL trajectories. Accounting for these identified age-associated differences in disease progression could positively impact patient management and drug development efforts.
