Data from a descriptive study of idiopathic Parkinson's disease were analysed aimed at getting a clearer picture of the impact of the disease on the community and the help available to patients and capers. Altogether 267 patients aged 40-92 were identified, and the median duration of disease in those in whom this could be assessed was 7-2 years.Of the 267 patients, 204 (76-4%) were living in the community, 51 alone. A total of 201 patients were taking levodopa, 29 out of 102 had retired early, and 60 out of 84 (71-4%) had given up driving. Most patients had symptoms at the time of study, and signs such as bradykinesia, rigidity, impaired speech, and abnormal gait were often moderate or severe. Of 214 patients whose disease was assessed using the scoring system of Hoehn and Yahr, 78 (36.4%) had grade 4 and 23 (10-7%) grade 5 disability. Despite this, however, 105 of 265 patients (39.6%)were not subject to regular medical review and only 57 of 227 patients (25.1%) had been seen by an occupational therapist, 16 (7 0%) by a physiotherapist, and 10 (4.4%) by a speech therapist.

A total of 227 patients with Parkinson's disease, and their age, sex-matched, non-Parkinsonian controls were assessed for their ability to cope with everyday activities. Fifty-four patients and 21 controls were living in a hospital or residential home for the elderly. The help given by informal and formal carers of the remaining 173 patients and 206 controls living in their own homes was also noted. The speech of 32 (14%) patients and four (2%) controls was unintelligible. Seventy patients were housebound compared with 26 controls. Consistently greater numbers of patients were dependent for self-care tasks such as eating a meal and bathing. Similarly more patients were dependent in household tasks. One hundred and nine (63%) patients and 139 (68%) controls had practical help from their families more than once a week. Parkinson's sufferers received more statutory support, but fewer were able to live alone. Patients with Parkinson's disease are considerably more disabled in all aspects of everyday life, but receive similar family support as patients without the disease.