My World of Parkinsonian Delights

Late Stage PD Progresses Independent of Patient Age

Well, here’s a cheerful thought for those of us with young onset Parkinson’s disease who now find ourselves slipping into the later stages of the disease.

According to an article published today in the Movement Disorder Virtual University, late stage PD doesn’t care how old you are when you encounter it.  It will progress at approximately the same rate if you are 55 as it would if you were 85.

The authors examined brains and clinical records of 129 pathologically confirmed cases of PD. For purposes of analysis, patients were grouped by age at death from PD-related complications (<70, 70-74, 75-79, 80-84, >84 years ). They focused on the timing of four disability-related milestones: visual hallucinations, regular falls, residential care, and dementia. Patients had experienced between zero and four of these milestones.

OK… I’ve experienced visual hallucinations (not all that frequently), I fall (not all that frequently), I’m not in residential care, and I am concerned about the onset of Parkinson’s Disease Dementia.  So what does this mean?

Results showed:

–There were no significant differences in disease duration between any of the age-at-death groups, with a mean duration of 13.7 years from onset to death.

–There was little variation in the temporal relationship between each milestone and death across the groupings, and none of the differences were significant. “On average, visual hallucinations precede death by 5.1 years, falls by 4.1 years, and dementia and need for residential care both by 3.3 years,” with dementia being the most consistent across the groups.

–Age at onset was not correlated with the interval from first milestone to death.

–Lewy body burden was proportional to the number of milestones accumulated, with limbic disease seen in those with 0-1 milestones, and increasing neocortical disease in those with 2-4 milestones.

Well, Yabba Dabba Freakin’ Doo! By the averages, I have about 3 years to live.

So, yes.  Maybe I WILL have that pint of ice cream tonight!

OK, do we have any salt to rub into this wound?

“Our observations have some practical applications. Visual hallucinations, frequent falling, and early cognitive decline should be absolute contraindications for deep brain stimulation surgery…A more benign prognosis should not be assumed when these milestones occur in relatively youthful patients.”

OK.  I had DBS before I had hallucinations, before I started falling and before I had these concerns about dementia.  No word if the DBS is going to hasten my death.

How ’bout some hot fudge on that ice cream, Jimmy!  And put a cherry on top.

So, set your timers, kiddies!  If I’m still blogging on June 8, 2013, we’ll have a party.

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