Document Detail


Clinical course and cause of death in elderly patients with idiopathic Parkinson's disease.
MedLine Citation:
PMID:  12411124     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To improve the therapeutic and preventive measure for elderly patients (75 years and over) with idiopathic Parkinson's disease (OEIPD). METHODS: Fifteen OEIPD patients were observed prospectively over a long period of time. Their diagnosis was confirmed by autopsy. Based on clinical and pathological data, the causes of death were analyzed. RESULTS: The mean clinical course in OEIPD patients was 6.2 +/- 3.6 years. The majority of the 15 patients were the akinetic type and the akinetic type with tremor (80.0%). In the late stages of disease (4.8 +/- 3.5 year), choking occurred in 12 OEIPD patients who received nasal feeding for an average of 4 months after the occurrence of choking. The most common complication in 12 patients was repeated pulmonary infections with an average rate of 2.9 +/- 1.9. The causes of death were bronchial pneumonia and shock induced by pulmonary infection (11 cases, accounted for 73.3%), acute myocardial infarction (2 cases), one case with cardiac rupture and one case with rupture of aortic aneurysm. CONCLUSIONS: The clinical course was shorter in OEIPD patients. Levodopa therapy should be started early in OEIPD patients. Bronchial pneumonia and infectious shock constitute the major cause of death and choking was one of the main causes of aspiration pneumonia. Nasal feeding should be started as early as possible after the appearance of choking. Silent aspiration can be reduced by teaching the patient to protect the airway by 'supraglottic swallowing'.
Authors:
Xinde Wang; Guangfa You; Haibo Chen; Xiaojie Cai
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chinese medical journal     Volume:  115     ISSN:  0366-6999     ISO Abbreviation:  Chin. Med. J.     Publication Date:  2002 Sep 
Date Detail:
Created Date:  2002-11-04     Completed Date:  2002-11-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7513795     Medline TA:  Chin Med J (Engl)     Country:  China    
Other Details:
Languages:  eng     Pagination:  1409-11     Citation Subset:  IM    
Affiliation:
Clinical Therapeutic and Diagnostic Center for Parkinson's Disease and Related Disorders, Beijing Hospital, China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Airway Obstruction / etiology
Brain / pathology
Cause of Death
Enteral Nutrition
Female
Humans
Lung / pathology
Male
Parkinson Disease / complications*,  mortality,  pathology

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