To determine the frequency and spectrum of complementary therapy (CT) use and its association with sociodemographic or disease-specific characteristics among Asian patients with Parkinson's disease (PD) in Singapore, we interviewed 159 patients using a structured questionnaire. Sixty-one percent (95% CI=55-67) of participants used at least one type of CT for PD, of which the most common were traditional medicine, acupuncture, and vitamins/health supplements. Among CT users, 40% (95% CI=32-48) subjectively reported some improvement of their symptoms. However, only 16% informed their physicians of their use of CT. Due to unequal follow-up times, a survival analysis approach was adopted for statistical analysis. The rate of starting CT use was 1.2/100 person months. At 3 years after PD diagnosis, 48% had started using CT. Among a subgroup of participants, those with a baseline Unified Parkinson's Disease Rating Scale motor score of more than 16 were 2.5 times more likely to use CT compared to those with a baseline score of 16 or less (P=0.031; 95% CI=1.1-5.8). CT use was not associated with age of onset of PD or other sociodemographic factors. The use of CT is high among Asian PD patients. Patients with more severe motor dysfunction at onset are more likely to use CT.

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At the group level, but not at the individual level, the mapping functions can accurately map the PDQ-8 outcomes to the EQ-5D utility index.

Both socio-demographic factors and disease-specific variables influence HRQoL in PD patients; the effects of culture-related factors on HRQoL should not be overlooked when assessing HRQoL in multi-cultural settings.

Data on the prevalence and severity of cognitive impairment among patients with newly diagnosed idiopathic Parkinson's disease (PD) is limited. Using a prospectively collected clinical database, we studied the longitudinal trend of mini-mental state examination (MMSE) change and baseline factors predictive for MMSE decline. One hundred six patients with mean age of 61.2 years and mean baseline MMSE of 27.8 +/- 2.3 were studied. MMSE increased by 0.4 points/year among patients without cognitive decline (n = 73) and decreased by 2.39 points/year among patients with cognitive decline (n = 33). Univariate analysis demonstrated education, age of diagnosis, depression, and diabetes mellitus to be associated with cognitive decline. Motor scores and hallucination were not associated with cognitive decline. Multivariate analysis demonstrated higher level of education to be protective (HR = 0.91, 95% CI 0.82-0.99, P = 0.047) and depression having borderline significance in predicting cognitive decline (HR = 2.00, 95% CI 0.97-4.15, P = 0.061). We found that 31% of newly diagnosed idiopathic PD patients have measurable cognitive decline at an early stage of disease. Higher education is protective while depression may be predictive of cognitive decline.