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Query: UMLS:C0030567 (Parkinson's disease)
 63,064 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty patients with Parkinson's disease underwent a detailed assessment of their psychiatric state using a standardized, semi-structured interview, the Present State Examination. Analysis of the interviews yielded a profile of depressive and neurotic syndromes. Comparing the results with population norms, however, revealed that the patients were distinguished only by high levels of depressed mood and loss of interest and poor concentration. In the majority of patients the range and severity of symptoms fell below the criteria for 'caseness'. Only four patients could be allocated to an ICD-9 class, two to 'neurotic depression', one to 'anxiety state' and one to 'phobic state'. This rate was almost identical to that found in the general population. Broader indices of psychiatric morbidity were related to the patients' levels of disability and cognitive function.
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PMID:Psychiatric morbidity in patients with Parkinson's disease. 232 Jul

The relative incidence of the major types of dementia disorders and the agreement rates between clinical and pathological diagnosis were analysed in consecutive autopsy series of 675 demented subjects from 3 hospitals (mean age 79.5 years, SD 9.6). Clinical assessment followed the DSM-III and ICD-9-NA criteria and NINCDS/ADRDA criteria for probable Alzheimer disease (AD) (McKhann et al. 1984), histological criteria for the diagnosis of AD those of the NIH/AARP Work Group (Khachaturian 1985) using a 4-degree rating scale for plaques and tangles in neocortex and hippocampus (Morris et al. 1988), and the criteria by Tierney et al. (1988) for 'pure' AD. Vascular dementia (MID) and other disorders were diagnosed according to current pathologic criteria. Clinical diagnosis of AD/SDAT was made in 59.2%, of MID in 21.7%, of mixed AD + MID in 3.1%, and of Parkinson's disease (PD) and other disorders in 16%. At autopsy, 76.7% fulfilled histological criteria for AD/SDAT, but only 60% were 'pure' forms, while 8.2% had additional features of PD and 7.9% coexisting vascular lesions indicating mixed SDAT + MID. 15.7% were MID with no or very little AD pathology, 7.4% other CNS disorders. 0.3% of the brains showed no abnormality beyond age-related changes. AD/SDAT had its highest incidence in a psychiatric population, MID and PD + SDAT in general and geriatric hospital cohorts. The overall coincidence rates for clinical and pathological diagnosis of AD/SDAT were 85.2%, for MIX and MID 60.5-61.9%, but only 51% for PD-PD/AD. These data and the results of other recent studies emphasize the need for more appropriate clinical and pathological criteria in the diagnosis of the dementias.
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PMID:Clinicopathological analysis of dementia disorders in the elderly. 235 19

The cause of motor neuron disease (MND) remains unknown although recent reports have suggested a possible rise in mortality rate. The present account describes age-specific patterns in morbidity rate and cross-sectional and cohort analyses of mortality rate, and compares these with those in multiple sclerosis and Parkinson's disease. First hospital admission rate for motor neuron disease (a proxy for incidence rates) rose steadily with age in males and females until the age of 75 years or more, but then fell, but only in females. This irregular pattern suggested the possibility of an environmental effect on certain older birth cohorts. The validity of the results was supported by a similar pattern in the two hospital regional authorities studied and the difference between this pattern and that found in multiple sclerosis and Parkinson's disease. Age-specific mortality rates of motor neuron disease between 15 and 64 years for males and females in England and Wales from 1940 to 1982 rose steadily with age. Mortality rates after the age of 65 fell in all female cohorts studied, but only in the earlier male cohorts. Unlike Parkinson's disease there was no strong birth cohort effect. However an analysis of Office of Population Censuses and Surveys (Registrar General) reports has revealed a slight increase in the age-specific mortality rate in both males and females aged 65 and over for successive birth cohorts born since 1900. Neither changes in ICD coding or in diagnostic habits could account for this pattern, which differed from that seen in Parkinson's disease. No such effect was seen in multiple sclerosis.
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PMID:Morbidity and mortality in motor neuron disease: comparison with multiple sclerosis and Parkinson's disease: age and sex specific rates and cohort analyses. 387 17

There is currently controversy as to the morphological basis of cognitive impairment in elderly schizophrenics. In contrast to previous findings, recent studies have found no increased frequency of Alzheimer's disease (AD) pathology in elderly schizophrenics. We examined 99 consecutive autopsy cases of patients over the age of 55 years from a psychiatric hospital who met the DSM-III-R and ICD.10 criteria for schizophrenia (mean age 69.5 +/- 8.25 years; mean duration of illness 35.15 +/- 10.1 years), 56% showing moderate to severe dementia. All brains were blindly reviewed for evidence of AD using CERAD criteria and Braak staging of neuritic AD lesions. "Definite" AD (CERAD C, Braak stage V) was seen in 2 cases aged 56 and 67 years, respectively [2% of total or 1/68 (1.4%) of those over age 65]. "Probable" AD (CERAD B, Braak stages IV-V) were seen in 5 cases aged 71-89 years (mean 79 years; 5% of total or 7.3% of those over age 65), and 1 case each with multiple cerebral infarcts and with Parkinson's disease pathology. In addition, 2 females aged 82 and 89 years, respectively, revealed senile dementia with tangles (NIA, CERAD negative; Braak stage IV), 1 with hippocampal sclerosis. The total incidence of definite and probable AD in this cohort was 7.1% or 8.7% for those over age 65. This is in line with other recent studies showing that the frequency of AD in elderly schizophrenics may be equal or even less than in the general population. The reasons for this negative association and the basis of cognitive deficits in elderly schizophrenics--those with dementia usually showing significantly lower brain weight--await further elucidation.
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PMID:No increased incidence of Alzheimer's disease in elderly schizophrenics. 992 27

We report a patient with Parkinson's disease treated with two pectorally implanted neurostimulators (NSs) who presented with a life-threatening ventricular tachyarrhythmia in whom an abdominal ICD was implanted. Testing during implantation showed that the NS did not affect the bipolar sensing of the ICD, even when the NSs were set at a frequency of 130 pulses/s with an output of 5 V and pulse width of 0.21 ms in a bipolar and a unipolar configuration. The ICD shock, however, did affect both NSs: there was a reset to the output Off state and there was a reset of the electrode polarities.
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PMID:Use of an implantable cardioverter defibrillator in a patient with two implanted neurostimulators for severe Parkinson's disease. 1087 97

Approximately 25% of patients with idiopathic Parkinson's disease (IPD) later develop dementia, with the typical characteristics as detailed in ICD-10 and DSM-IV. Differential diagnosis has to exclude dementia due to Lewy bodies, subcortical vascular encephalopathy and subcortical dementia due to progressive supranuclear paralysis or corticobasal degeneration. Several studies showed promising results for cholinesterase inhibitors such as donepezile, rivastigmine and galantamine. The demented Parkinsonian patients then present with improvement in cognitive function while motor skills do not deteriorate.
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PMID:Dementia in idiopathic Parkinson's syndrome. 1567 22

Administrative databases have the potential to assess quality and cost of care for parkinsonism and Parkinson's disease. However, the validity of findings is limited by our understanding of how cases are identified. Patient records listing International Classification of Diseases, Version 9, Clinical Modification (ICD-9 CM) codes for parkinsonism (n = 2,076) and dopaminergic medications (n = 2,798) were pulled from fiscal years 1999 to 2001 for patients in the Pacific Northwest Veterans Administration. Samples of these records (n = 397) and records without these ICD-9 CM codes (n = 500) were reviewed, and clinical data were extracted. The accuracy of administrative data to identify and distinguish between Parkinson's disease and parkinsonism was calculated. A total of 37.9% of parkinsonism cases were detected using pharmacy data and ICD-9 CM codes compared to 18.7% by using ICD-9 CM codes alone. The ICD-9 CM code for paralysis agitans (332.0) did not distinguish between probable Parkinson's disease and other causes of parkinsonism, whereas the ICD-9 CM code for degenerative basal ganglia disorder (333.0) predicted having secondary parkinsonism (odds ratio [OR] = 5.0) as well as dopa-responsiveness in patients without secondary parkinsonism (OR = 4.5). Administrative data are limited in the ability to identify parkinsonism. The ICD-9 CM code, 332.0, which is generally considered the code to identify Parkinson's disease, did not distinguish between parkinsonism and Parkinson's disease.
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PMID:Identifying and distinguishing cases of parkinsonism and Parkinson's disease using ICD-9 CM codes and pharmacy data. 1583 54

In this article we present trends in mortality from Alzheimer's disease, Parkinson's disease and dementia in England and Wales from 1979 to 2004. We describe the impact of mortality coding changes on the underlying cause of death, particularly the introduction of ICD-10 in 2001. We present rates for all mentions of the conditions on death certificates to interpret trends better. Mortality rates for the three conditions showed varying trends over the time period examined. Between 1985 and 2004, Alzheimer's disease showed a dramatic increase. Trends in mentions of dementia differed between males and females, with rates being relatively stable among males, but increasing among females. Rates for Parkinson's disease declined over this period.
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PMID:Trends in mortality from Alzheimer's disease, Parkinson's disease and dementia, England and Wales, 1979-2004. 1675 77

The higher prevalence of depression in specific diseases and older persons is discussed. This prevalence varies greatly according to the method used to collect data. A risk group can only be defined if information on diseases and other influencing factors are collected uniformly. The target diagnoses Parkinson's disease, stroke, myocardial infarction, cancer, diabetes mellitus, chronic pain, multiple infarct syndrome, Alzheimer's and other dementia were recorded from 1208 geriatric patients of the ZAGF municipal hospital in Munich, Germany. Logistic regression was used to identify chronic pain as the main cofactor for an association with depression (clinical diagnoses by ICD-10) and depressive symptoms (via GDS [Geriatric Depression Scale]). This association was also found for multimorbid patients with chronic pain. Impairment of the activities of daily living and the clinical setting were important additional cofactors. Pain patients are therefore at higher risk for depression.
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PMID:[Relation between certain diseases and frequency of depression in geriatric patients]. 1682 Oct 65

With a prevalence of 40%, depression is the most frequent psychiatric diagnosis in Parkinson's disease. Quality of life in Parkinson's patients is severely restricted. There is still no clear evidence concerning the link between these disorders - findings exist that indicate common neurodegenerative processes. At the same time depression seems to develop as a dysfunctional coping reaction to the motoric, emotional, and social restrictions of Parkinson's disease. The authors point out particular features of the depressive symptom profile in patients with Parkinson's disease and recommend a step-by-step approach to assessing depression: screening, assessment by means of the ICD-10 criteria, quantitative evaluation of depressivity, and assessment of suicidality. A survey of current treatment options is provided: pharmacological, somatic, and psychological approaches are introduced and evaluated with respect to effectiveness in this special group of patients.
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PMID:[Depression in Parkinson's disease. Assessment and treatment]. 1745 26


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