TY - JOUR
T1 - Prodromal symptoms and early detection of Parkinson's disease in general practice
T2 - A nested case-control study
AU - Plouvier, Annette O.A.
AU - Hameleers, Renier J.M.G.
AU - Van Den Heuvel, Eva A.J.
AU - Bor, Hans H.
AU - Olde Hartman, Tim C.
AU - Bloem, Bastiaan R.
AU - Van Weel, Chris
AU - Lagro-Janssen, Antoine L.M.
PY - 2014/8
Y1 - 2014/8
N2 - Background: Timely diagnosis of Parkinson's disease (PD), facilitating early intervention, depends largely on the GP's awareness of early symptomatology. For general practice, it is unknown which prodromal symptoms (symptoms preceding the typical motor symptoms of PD) demand the GP's alertness. Objective: To assess prodromal symptoms that should alert the GP to the possibility of PD in primary care patients. Methods: A nested case-control study was carried out in a population of approximately 12 000 patients registered in the Continuous Morbidity Registration database affiliated with the University of Nijmegen in the Netherlands. The database pools subject data from four primary care practices. The subjects comprised all 86 patients diagnosed with PD between 1972 and 2007, and 78 controls, matched by sex, age, socioeconomic status and primary care practice. The primary measures of outcome were the prodromal symptoms presenting in the two years prior to the diagnosis of PD. The number (and type) of referrals and diagnostic tests were also assessed. Results: In the two-year period prior to diagnosis, PD patients more often presented with functional somatic symptoms, constipation, hyperhidrosis and sleep disorders than controls. Patients also more frequently experienced more than one prodromal symptom and were more often referred within the primary care team or to a medical specialist. Conclusions: Prodromal symptoms of PD are encountered in general practice. GPs should be alert when patients present with multiple prodromal symptoms in a two-year period, especially considering the benefits of early intervention, and the future possibilities for disease-modifying therapy.
AB - Background: Timely diagnosis of Parkinson's disease (PD), facilitating early intervention, depends largely on the GP's awareness of early symptomatology. For general practice, it is unknown which prodromal symptoms (symptoms preceding the typical motor symptoms of PD) demand the GP's alertness. Objective: To assess prodromal symptoms that should alert the GP to the possibility of PD in primary care patients. Methods: A nested case-control study was carried out in a population of approximately 12 000 patients registered in the Continuous Morbidity Registration database affiliated with the University of Nijmegen in the Netherlands. The database pools subject data from four primary care practices. The subjects comprised all 86 patients diagnosed with PD between 1972 and 2007, and 78 controls, matched by sex, age, socioeconomic status and primary care practice. The primary measures of outcome were the prodromal symptoms presenting in the two years prior to the diagnosis of PD. The number (and type) of referrals and diagnostic tests were also assessed. Results: In the two-year period prior to diagnosis, PD patients more often presented with functional somatic symptoms, constipation, hyperhidrosis and sleep disorders than controls. Patients also more frequently experienced more than one prodromal symptom and were more often referred within the primary care team or to a medical specialist. Conclusions: Prodromal symptoms of PD are encountered in general practice. GPs should be alert when patients present with multiple prodromal symptoms in a two-year period, especially considering the benefits of early intervention, and the future possibilities for disease-modifying therapy.
KW - Early diagnosis
KW - General practice
KW - Parkinson disease
KW - Prodromal symptoms
KW - Somatoform disorders
UR - http://www.scopus.com/inward/record.url?scp=84904718223&partnerID=8YFLogxK
U2 - 10.1093/fampra/cmu025
DO - 10.1093/fampra/cmu025
M3 - Article
SN - 0263-2136
VL - 31
JO - Family Practice
JF - Family Practice
IS - 4
M1 - 25
ER -