Natural history and effectiveness of early detection of Parkinson’s disease: results from two community‐based programmes in Taiwan (KCIS no. 11)

Liou, Horng-Huei; Wu, Chia Yun; Chiu, Yueh‐Hsia; Yen, Amy Ming Fang; Chen, Rong Chi; Chen, Ta Fu; Chen, Chih Chuan; Hwang, Yuarn Chung; Wen, Ying; Chen, Chien-Jen

doi:10.1111/j.1365-2753.2007.00832.x

Cited by 10 publications

(9 citation statements)

References 17 publications

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“…Patients in H&Y 1 to 3 were assumed to have an excess mortality rate equal to the newly diagnosed cohort; the H&Y 4 rate was assumed to equal the AAD cohort; and the H&Y 5 rate was assumed to equal the institutionalized cohort. Previous studies have also demonstrated an association between PD progression and mortality …”

Section: Methodsmentioning

confidence: 79%

An economic model of Parkinson's disease: Implications for slowing progression in the United States

et al. 2013

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Multiple studies describe progression, dementia rates, direct and indirect costs, and health utility by Hoehn and Yahr (H&Y) stage, but research has not incorporated these data into a model to evaluate possible economic consequences of slowing progression. This study aimed to model the course of Parkinson's disease (PD) and describe the economic consequences of slower rates of progression. A Markov model was developed to show the net monetary benefits of slower rates of progression. Four scenarios assuming hypothetical slower rates of progression were compared to a base case scenario. A systematic literature review identified published longitudinal H&Y progression rates. Direct and indirect excess costs (i.e., healthcare costs beyond what similar patients without PD would incur), mortality rates, dementia rates, and health utility were derived from the literature. Ten publications (N = 3,318) were used to model longitudinal H&Y progression. Base case results indicate average excess direct costs of $303,754, life-years of 12.8 years and quality-adjusted life-years of 6.96. A scenario where PD progressed 20% slower than the base case resulted in net monetary benefits of $60,657 ($75,891 including lost income) per patient. The net monetary benefit comes from a $37,927 decrease in direct medical costs, 0.45 increase in quality-adjusted life-years, and $15,235 decrease in lost income. The scenario where PD progression was arrested resulted in net monetary benefits of $442,429 per patient. Reducing progression rates could produce significant economic benefit. This benefit is strongly dependent on the degree to which progression is slowed.

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Section: Methodsmentioning

confidence: 79%

An economic model of Parkinson's disease: Implications for slowing progression in the United States

et al. 2013

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“…This survey was part of a population screening service, the Keelung Community-Based Integrated Screening (KCIS) program. The implementation and preliminary findings of the KCIS program have been described in detail elsewhere [19][20][21][22][23] . Briefly, the KCIS program is a multiple disease screening service targeted at residents over 30 years old living in Keelung.…”

Section: Keelung Population-based Screenmentioning

confidence: 99%

“…In order to cover at least one round of screening for each resident from 1999 to 2005, every year we invited participants based on the residence registry to attend the KCIS program at screening centers covering 7 districts of Keelung City. To investigate the prevalence rate of IPD, the IPD survey was integrated into this screening service from January 1, 2001 to December 31, 2001 [20] . All screening activities were implemented in an administrative unit, called 'Lii'.…”

Section: Keelung Population-based Screenmentioning

confidence: 99%

Different Prevalence Rates of Parkinson’s Disease in Urban and Rural Areas: A Population-Based Study in Taiwan

Chen¹,

Chen²,

Hwang

et al. 2009

Neuroepidemiology

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Background: Rural living has long been debated as a risk factor for idiopathic Parkinson’s disease (IPD). But few community-based studies compared this difference between urban and rural areas. Methods: Population-based surveys by neurologists using a standardized diagnostic protocol were conducted in the urban areas of Keelung City and compared the prevalence rates of IPD with those we had previously determined in the rural area of Ilan County, Taiwan. Subjects were diagnosed with IPD when at least 2 of the 4 cardinal signs of parkinsonism were present and by exclusion of secondary parkinsonism. Gender-specific age-standardized prevalence rates of IPD by using the 1970 and 2000 US censuses were calculated for comparison. Results: The participation rate was 84.9%. The crude prevalence rate of IPD in persons aged 40 years and over was 706 (95% CI: 551–864) per 100,000 population. The age-adjusted prevalence rates by using the 1970 US census were 633 (95% CI: 620–646) for people aged 40 and over and 230 (95% CI: 227–234) for all ages. Our results were similar to those obtained in Sicily, Rotterdam, and 3 communities in China. Moreover, the prevalence rates of IPD in Keelung, the urban area studied, were twice as high as those in Ilan, the rural area studied (p < 0.001). Conclusions: Our results suggest that urban living is more important as a risk factor for IPD development than rural living in Taiwan.

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“…To the Editor : Previous studies of the early detection of idiopathic Parkinson's disease (IPD) raised the possibility of introducing population‐based screening to detect IPD in the early stage . It is therefore of great interest to assess the IPD detection rates of different methods.…”

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confidence: 99%

Active and Passive Methods of Detecting Parkinson's Disease

Wen

Yen

Chiu

et al. 2015

J American Geriatrics Society

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speed was found to be directly correlated with SPMSQ (P = .002) after adjustment for blood pressure and eGFR. DISCUSSIONParticipants had many comorbidities and used many drugs an on average had mild cognitive impairment and slow gait speed. Nevertheless, they had an overall satisfactory compensation of hypertension. Participants with median clinic SBP less than 140 mmHg and orthostatic SBP less than 135 mmHg had poorer cognitive performance. Participants with greater cognitive decline were older and had slower gait speed and lower BP. Conversely, participants with better cognitive status had higher seated and orthostatic SBP, with the highest SBP detected being 160 mmHg. Hypertension is associated with white matter hyperintensities (WMHs), and WMHs may influence mobility, cognition, and mood, 8 although excessive reduction of BP promotes progression of brain WMHs and cognitive impairment. 9 These findings support the idea that BP values play a critical role in the association between slow gait speed and cognitive impairment in older adults with arterial hypertension. In very old adults, the target for BP should not be too strict, because of the negative effect of lower BP on cognitive function and mobility. Walking speed may be a useful way to identify elderly adults with arterial hypertension with poor prognosis. 10 Physicians who treat elderly adults with arterial hypertension should always assess gait speed and cognitive status using simple, validated, reliable, rapid, inexpensive tests.

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Natural history and effectiveness of early detection of Parkinson’s disease: results from two community‐based programmes in Taiwan (KCIS no. 11)

Abstract: The present study recommended a 5-yearly screening programme, with 74% of PD cases prevented from progressing to H-Y stage III or worse within 10 years of diagnosis, and leading to a corresponding 26% reduction in mortality.

Cited by 10 publications

References 17 publications

An economic model of Parkinson's disease: Implications for slowing progression in the United States

An economic model of Parkinson's disease: Implications for slowing progression in the United States

Different Prevalence Rates of Parkinson’s Disease in Urban and Rural Areas: A Population-Based Study in Taiwan

Active and Passive Methods of Detecting Parkinson's Disease

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