On 29 March at 14 Liis Kadastik-Eerme will defend her doctor thesis "Parkinson’s disease in Estonia: epidemiology, quality of life, clinical characteristics and pharmacotherapy".
Professor Pille Taba (dr. med.), Institute of Clinical Medicine, University of Tartu
Professor Toomas Asser (knd (meditsiiniteadused), Institute of Clinical Medicine, University of Tartu
Professor Regina Katzenschlager (MD, PhD), Department of Neurology, Wiener Krankenanstaltenverbund, Vienna, Austria
Summary:Parkinson’s disease is the most common neurodegenerative disease causing movement problems. Its prevalence is about 1% among people over 60 years. The first epidemiologic study on Parkinson’s disease that was conducted 20 years ago in the County of Tartu, found the prevalence and incidence estimates to be 152/100 000 and 17/100 000, respectively. Patients with Parkinson’s disease have a 1.5-folded higher risk of dying compared to the general population. Clinical cardinal manifestations of Parkinson’s disease include tremor, bradykinesia, rigidity and postural instability. In addition to the motor features, the clinical picture also involves the non-motor symptoms – cognitive and emotional disorders, sleep and urinary problems, fatigue, pain, etc.
Levodopa is the most effective antiparkinsonian medication, however, its long-term use is related to the emergence of motor complications. The primary aim of the present thesis was to describe the epidemiologic characteristics of Parkinson’s disease in the County of Tartu. We also aimed at analysing the clinical profile of the patients, including the frequency and associative factors of motor complications and non-motor symptoms. An additional aim was to study the factors related to the health-related quality of life of the patients. The population-based epidemiologic study demonstrated increase in the prevalence of Parkinson’s disease, while the incidence has remained stable compared to the previous study. The proportion of patients with more severe stages of the disease has increased. Death certificates may underrepresent the real burden of this disease – out of all the deceased subjects with clinically diagnosed Parkinson’s disease, only about 50% had the disease noted on their death certificates. Mortality in patients with early Parkinson’s disease was not different compared to the general population. About a quarter of patients had some kind of motor complications. Cognitive impairment, fatigue, urinary and nighttime sleep problems were the most frequent non-motor symptoms. Depression, motor and non-motor experiences of daily living were the most important factors affecting the quality of life of the patients with Parkinson’s disease. Results of the motor assessments performed by neurologists might not correspond to the quality of life evaluated by the patients.