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Title: Epidemiological study of young and later onset Parkinson's disease
Author: Wickremaratchi, Mirdhu
ISNI:       0000 0004 2748 6872
Awarding Body: Cardiff University
Current Institution: Cardiff University
Date of Award: 2009
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Parkinson's disease (PD) is a common neurodegenerative condition and the risk of developing it is age dependent, the prevalence increasing with advancing age. There are relatively little published data on frequency and clinical features of Young Onset Parkinson's disease (YOPD) and it is uncertain whether this subgroup of PD is a different disease entity to later onset Lewy body PD. Investigation of this question is the main focus of this research thesis. This work has two components—the first provides an estimate of the prevalence of PD in Cardiff and describes age at onset, the second is a community based case control study of YOPD and later onset PD (LOPD) using the prevalence cohort as the main source of cases. The prevalence of PD in Cardiff is similar to the weighted average of previous PD prevalence studies in the UK over the past 42 years. Our crude prevalence estimate was 130 per 105 (95% CI 117,144) and the age standardised prevalence 142 per 105 (95% CI 128,156) using 1997 England and Wales population figures as a standard population. Significant clinical differences were identified in YOPD as compared to LOPD. YOPD patients reported less hyposmia, constipation and sleep disturbance in the pre-motor stage, but more depression, paraesthesiae and sleep disturbance and less dementia in established disease than LOPD. YOPD presented more commonly with akinetic rigid symptoms and had a lower frequency of tremor. YOPD was much more likely to involve dystonia and treatment related dyskinesia than LOPD. These results support the hypothesis that PD is a clinically heterogeneous condition and that significant differences are seen according to age at onset.
Supervisor: Not available Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
EThOS ID:  DOI: Not available