Wagner M L, Fedak M N, Sage J I, Mark M H
Department of Pharmacy Practice, College of Pharmacy, Rutgers, State University of New Jersey, Piscataway 08855, USA.
Ann Clin Lab Sci. 1996 Sep-Oct;26(5):389-95.
The incidence of complications associated with disease and treatment was compared in younger versus elderly patients with Parkinson's disease (PD). One hundred sixty-five patient records were divided according to patient age into two groups ("younger," 41 to 64, and "elderly," > or = 65 years) and reviewed for the incidence of dyskinesias, fluctuations, freezing, psychosis, dementia, depression, and insomnia. Younger patients had a greater incidence of chorea (75.8 percent vs 49.5 percent), dystonia (82.3 percent vs 49.0 percent), fluctuations (90.1 percent vs 68.1 percent), depression (73.2 percent vs 36.8 percent), and insomnia (57.9 percent vs 18.1 percent). There were no significant differences in the incidence of freezing, dementia, or psychosis. At the time of the first adverse event, there was no difference in patient characteristics such as gender, lag time from disease diagnosis to levodopa initiation, disease symptoms at the time of diagnosis, levodopa dose, or concomitant drug use despite the fact that the older group had a longer duration of disease, higher Hoehn and Yahr stage, an older age at onset of PD, and longer duration of levodopa use. Younger patients with PD experience a greater incidence of adverse effects than do elderly PD patients. The spectrum of adverse effects is comparable to those of young-onset (< or = 40 years) patients.
对帕金森病（PD）年轻患者与老年患者中与疾病和治疗相关的并发症发生率进行了比较。165份患者记录根据患者年龄分为两组（“年轻组”，41至64岁，“老年组”，≥65岁），并对异动症、症状波动、冻结现象、精神病、痴呆、抑郁和失眠的发生率进行了回顾。年轻患者舞蹈症（75.8%对49.5%）、肌张力障碍（82.3%对49.0%）、症状波动（90.1%对68.1%）、抑郁（73.2%对36.8%）和失眠（57.9%对18.1%）的发生率更高。冻结现象、痴呆或精神病的发生率无显著差异。在首次出现不良事件时，尽管老年组疾病持续时间更长、Hoehn和Yahr分期更高、帕金森病发病年龄更大且左旋多巴使用时间更长，但在患者特征如性别、从疾病诊断到开始使用左旋多巴的延迟时间、诊断时的疾病症状、左旋多巴剂量或合并用药方面并无差异。帕金森病年轻患者比老年患者出现不良反应的发生率更高。不良反应谱与早发型（≤40岁）患者相当。
