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Departments of Neurology, UCLA School of Medicine, Los Angeles, CA (Ms. Diamond and Dr. Markham)
University of Colorado, Denver, CO (Dr. Hoehn)
Cornell University Medical School (Dr. McDowell), New York, NY
Mayo Clinic, Scottsdale, AZ (Dr. Muenter)
We examined longitudinal disability scores in 54 patients with Parkinson's disease followed for 6 years at UCLA. We sorted data into 3 groups based on age at onset of symptoms: group A, onset under 50 years; group B, 50 to 59 years; group C, 60 years or older. There were no significant differences between groups initially. All 3 groups improved dramatically when levodopa was given, but group A showed significantly less disability in years 4, 5, and 6 than did group C. The groups did not differ with respect to side effects. To determine if age at onset affected mortality, we sorted records from 4 geographically diverse centers into the same 3 groups. Results on 359 patients followed for 3,314 person-years, covering a period of 17 years after onset of symptoms, showed that group A had the most favorable observed-to-expected mortality ratio, 1.82, compared with 2.17 and 2.20 for groups B and C respectively, but the difference was not statistically significant. Results from the disability analyses indicate that patients with onset of Parkinson's disease under 50 years of age may have a more favorable prognosis than those whose symptoms begin in later years.
Address correspondence and reprint requests to Ms. Diamond, Department of Neurology, UCLA School of Medicine, Los Angeles, CA 90024–1769.
Received December 2, 1988. Accepted for publication in final form March 21, 1989.
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