Prior GID diagnosis impacts health outcomes of patients with Parkinson's

UCBJun 16 2011

A new study investigating the incidence and impact of gastrointestinal disorders (GID) among patients with Parkinson's disease (PD) found that patients who received both a PD diagnosis and a prior GID diagnosis appeared to have worse health outcomes compared to patients who received a diagnosis for PD with no prior GID diagnosis.  This retrospective observational analysis of US administrative health claims data was published this month in the Journal of Parkinson's Disease.  

The study concluded that the majority of people diagnosed with PD acquired at least one GID, with incidence reaching 65% of patients four years after diagnosis.  In addition, PD patients with pre-existing GIDs before PD diagnosis were more likely to develop neurological, movement and urinary disorders, and may have required a higher level of healthcare utilization and increased healthcare costs.  

"This analysis reinforced the clinical impact of gastrointestinal disorders among people living with Parkinson's disease," commented study author, Dr. Florent Richy, Head of Global Epidemiology, UCB and Adjunct Professor of Epidemiology at the University of Liege, Belgium. "These patients tended to have worse health outcomes and required a higher level of care overall."

GIDs – such as difficulty in swallowing (dysphagia), delayed gastric emptying (gastroparesis) and bowel dysfunction – are the more commonly observed non-motor symptoms of PD.  GIDs affect nearly all aspects of the gastrointestinal system, and tend to worsen as PD progresses.  

Study Findings

Increased incidence over time of GIDs in patients diagnosed with PD

• 29% of patients diagnosed with PD had been diagnosed with GIDs in the previous year
• After four years, the proportion of PD patients diagnosed with GIDs increased to:
  • 50% for patients younger than 65 years of age
  • 68% for patients between 65 and 75 years of age
  • 72% for patients older than 75 years of age

PD patients with prior GID diagnosis experienced higher incidences of the following, according to a subset analysis

• Dysfunctions of the neuropsychiatric, autonomic and sensory systems
  • Depression – 1.23-fold higher in PD patients with GIDs
  • Anxiety – 1.61-fold higher in PD patients with GIDs
  • Psychosexual dysfunction – 8.00-fold higher in PD patients with GIDs
  • Ataxia – 1.24-fold higher in PD patients with GIDs
  • Pain – 1.29-fold higher in PD patients with GIDs
• Motor, urogenital, and cardiovascular disturbances
  • Movement disorders – 1.39-fold higher in PD patients with GIDs
  • Urinary incontinence – 1.43-fold higher in PD patients with GIDs
  • Falls – 1.44-fold higher in PD patients with GIDs
• Increased healthcare utilization and costs
• ER visits – 1.42-fold higher in PD patients with GIDs
• Drugs prescribed for pain, sleep disorders or depression – 1.06-fold higher in PD patients with GIDs
• PD-related healthcare costs – 1.13-fold higher in PD patients with GIDs
• Non-PD-related healthcare costs – 1.12-fold higher in PD patients with GIDs