Reid W G
Department of Geriatric Medicine, University of Sydney, New South Wales, Australia.
Int Psychogeriatr. 1992;4 Suppl 2:147-60.
One hundred and seven newly diagnosed, untreated patients with Parkinson's disease (PD) were divided into two groups according to their age at reported onset of symptoms. Of these, 79 patients were under age 70 (early-onset) and 28 patients were age 70 and over (late-onset). The group of 50 control subjects comprised spouses, friends of the PD patients, and community volunteers. The patients were participants in a multicenter drug study of Parkinson's disease. Each had received a detailed neurological and neuropsychological assessment in the baseline placebo phases of the study. Thirty-4 patients with early-onset and 12 patients with late-onset were reassessed 3 years after treatment with low-dose levodopa, with bromocriptine, or with a combination of the two drugs. The results of the baseline phase of the study revealed that 8% of the early-onset group and 32% of the late-onset group were classified as demented. The 3-year follow-up revealed that the prevalence of dementia had increased to 17% in the early-onset group and to 83% in the late-onset group. This study confirms that at least two distinct subtypes of Parkinson's disease exist. The subtypes differ both clinically and neuropsychologically. The age at onset of symptoms is a critical determinant of the rate and type of cognitive decline in Parkinson's disease.
107名新诊断的、未经治疗的帕金森病（PD）患者根据报告的症状发作年龄分为两组。其中，79名患者年龄在70岁以下（早发型），28名患者年龄在70岁及以上（晚发型）。50名对照受试者包括PD患者的配偶、朋友和社区志愿者。这些患者参与了一项帕金森病的多中心药物研究。在研究的基线安慰剂阶段，每位患者都接受了详细的神经学和神经心理学评估。34名早发型患者和12名晚发型患者在接受低剂量左旋多巴、溴隐亭或两种药物联合治疗3年后进行了重新评估。研究基线阶段的结果显示，早发型组中8%的患者和晚发型组中32%的患者被归类为痴呆。3年随访显示，早发型组痴呆患病率增至17%，晚发型组增至83%。这项研究证实，帕金森病至少存在两种不同的亚型。这些亚型在临床和神经心理学方面都有所不同。症状发作年龄是帕金森病认知衰退速度和类型的关键决定因素。
