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Aging and disease    2018, Vol. 9 Issue (1) : 8-16     DOI: 10.14336/AD.2017.0204
Orginal Article |
Clinical Profile of Chinese Long-Term Parkinson’s Disease Survivors With 10 Years of Disease Duration and Beyond
Sun Qian, Wang Tian, Jiang Tian-Fang, Huang Pei, Wang Ying, Xiao Qin, Liu Jun*, Chen Sheng-Di*
Department of Neurology & Collaborative Innovation Center for Brain Science, Ruijin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China
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Abstract  Background

Parkinson’s disease (PD) patients with 10 years or more survival (PD-10) are not well characterized. The aim of this study was to evaluate the main issues facing PD-10 patients and identify factors that independently contributed to quality of life (QoL).


A group of 121 PD-10 patients recruited from outpatient clinics participated in this cross-sectional study. Data on demographic and clinical factors were collected. Multiple linear regression analyses were conducted to identify determinants of poor QoL.


The entire PD-10 patients had disease duration ranging from 10 to 23 years, with 84.2% of the total cohort skewed to between 10 and 15 years’ duration. The PD-10 patients had great frequency of left-sided onset, increased motor and non-motor symptoms as well as inferior QoL. The more advanced stage of disease in PD-10 patients was associated with motor phenotype, freezing of gait, higher UPDRS sub-scores and levodopa equivalent dose, less balanced confidence, fatigue, anxiety, depression, reduced quality of life and worse Timed Up & Go performance. Self-reported mood symptoms, decreased balance confidence and reduced daily activities were the three factors most closely associated with poorer QoL, but excessive daytime sleepiness and long disease duration additionally contributed to the explanatory power.


This is the first report to investigate the clinical characteristics of Chinese PD-10 patients. Our study may elucidate an important clue for understanding PD-10 patients in clinical practice and identifying patients with PD at risk for reduced QoL.

Keywords Parkinson’s disease      longevity      motor and non-motor symptoms      quality of life     
Corresponding Authors: Liu Jun,Chen Sheng-Di   
About author:

These authors contributed equally to this work.

Issue Date: 01 February 2018
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Sun Qian
Wang Tian
Jiang Tian-Fang
Huang Pei
Wang Ying
Xiao Qin
Liu Jun
Chen Sheng-Di
Cite this article:   
Sun Qian,Wang Tian,Jiang Tian-Fang, et al. Clinical Profile of Chinese Long-Term Parkinson’s Disease Survivors With 10 Years of Disease Duration and Beyond[J]. Aging and disease, 2018, 9(1): 8-16.
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Figure 1.  Distribution of patients with disease duration of 10 years or greater.
OverallH-Y ≥ 3.0
H-Y < 3.0
Age (years)66.46 ± 8.5767.25 ± 8.6465.84 ± 8.520.37
Age at onset (years)53.70 ± 8.5354.21 ± 8.4953.31 ± 8.610.57
Sex, Male, n (%)67 (55.37)25 (47.17)42 (61.76)0.11
Disease duration (years)12.84 ± 2.9213.25 ± 2.8712.53 ± 2.930.07
Asymmetry (left), n (%)73 (60.33)33 (62.26)40 (58.82)0.70
Hoehn &Yahr stage2.70 ± 0.773.40 ± 0.572.16 ± 0.35<0.01*
UPDRS-I score3.95 ± 2.424.85 ± 2.543.25 ± 2.08<0.01*
UPDRS-II score17.17 ± 6.2520.15 ± 5.9614.84 ± 5.47<0.01*
UPDRS-III score34.31 ± 11.8938.66 ± 11.7130.93 ± 10.97<0.01*
Motor fluctuations, n (%)78 (64.46)39 (73.58)39 (57.35)0.06
Dyskinesia, n (%)28 (23.14)13 (24.53)15 (22.06)0.75
TD phenotype, n (%)26 (21.49)4 (7.55)22 (32.35)<0.01*
PIGD phenotype, n (%)78 (64.46)39 (73.58)39 (57.35)0.06
Intermediate, n (%)17 (14.05)10 (18.87)7 (10.29)0.18
FOG, n (%)75 (61.98)44 (83.02)31 (45.59)<0.01*
ABC (%)64.40 ± 26.6450.25 ± 27.9975.42 ± 19.52<0.01*
Standardized TUG19.98 ± 21.8828.82 ± 30.6713.47 ± 6.83<0.01*
LED (mg)954.52 ± 359.691033.40 ± 326.46893.05 ± 374.500.03*
PDSS98.79 ± 26.8392.64 ± 26.24103.59 ± 26.480.03*
ESS8.40 ± 6.248.21 ± 5.758.54 ± 6.630.77
SS-165.42 ± 3.194.91 ± 3.365.82 ± 3.020.12
RBDSQ5.87 ± 2.666.06 ± 2.535.72 ± 2.770.49
HAMA14.48 ± 9.2816.66 ± 9.7412.78 ± 8.590.02*
HAMD10.79 ± 6.2013.04 ± 6.469.03 ± 5.42<0.01*
FSS42.32 ± 18.0146.21 ± 16.6239.29 ± 18.570.03*
MMSE26.11 ± 4.0025.74 ± 4.0026.40 ± 4.000.15
Table 1  Demographic and motor characteristics for PD patients with 10 years or more disease duration.
Table 2  showed the frequency distribution of medication in PD-10 patients. Although 100% patients were taking levodopa, only 9.09% (11/121) of those were taking levodopa alone and the majority of those were also taking dopamine agonists or any other PD medication. Among PD-10 patients, 43.80% (53/121) of patients were taking three PD medication, 83.02% (44/53) of whom were taking the combination of dopamine agonists, levodopa and other anti-parkinson drugs. Although higher percentage of PD-10 patients with H-Y ≥3.0 was taking COMT inhibitor (39.62% vs. 19.12%), the percentages of taking amantadine (28.30% vs. 48.53%) for patients with H-Y ≥3.0 were significantly lower. We did not observe statistically significant differences in the proportions of levodopa, dopamine agonist, MAO-B inhibitor, anticholinergics and types of PD medication used between PD-10 patients with and without H-Y ≥3.0.
OverallH-Y ≥ 3.0
H-Y < 3.0
Levodopa121 (100%)53 (100%)68 (100%)-
Dopamine agonist79 (65.29%)30 (56.60%)49 (72.06%)0.08
MAO-B inhibitor33 (27.27%)16 (30.19%)17 (25.00%)0.53
COMT inhibitor34 (28.10%)21 (39.62%)13 (19.12%)0.01*
Amantadine48 (39.67%)15 (28.30%)33 (48.53%)0.02*
Anticholinergics26 (21.49%)9 (16.98%)17 (25.0%)0.29
One PD medication alone
(Levodopa alone)
11 (9.09%)7 (13.21%)4 (5.88%)0.21
Two PD medication32 (26.45%)14 (26.42%)18 (26.47%)0.99
Three PD medication53 (43.80%)22 (41.51%)31 (45.59%)0.65
Four PD medication19 (15.70%)7 (13.21%)12 (17.65%)0.51
Five PD medication6 (4.96%)3 (5.66%)3 (4.41%)1.00
Table 2  PD medication of H-Y ≥ 3.0 and H-Y < 3.0 patients.
OverallH-Y ≥ 3.0
H-Y < 3.0
PDQ-39 mobility (%)34.94 ± 27.8550.19 ± 27.3923.05 ± 21.90<0.01*
PDQ-39 ADL (%)32.71 ± 23.4943.71 ± 22.0024.14 ± 21.04<0.01*
PDQ-39 emotion (%)32.54 ± 27.0839.86 ± 29.4026.84 ± 23.820.01*
PDQ-39 stigma (%)29.49 ± 28.1732.67 ± 27.7527.02 ± 28.460.20
PDQ-39 social support (%)12.81 ± 22.1819.81 ± 27.997.35 ± 14.290.01*
PDQ-39 cognition (%)37.96 ± 23.4842.10 ± 24.5834.74 ± 22.250.09
PDQ-39 communication (%)25.21 ± 25.1330.66 ± 27.9220.96 ± 22.000.06
PDQ-39 pain (%)34.16 ± 26.9742.77 ± 24.0227.45 ± 27.40<0.01*
PDQ-39 summary index (%)29.98 ± 17.8037.72 ± 18.9623.94 ± 14.28<0.01*
Table 3  PDQ-39 scores of H-Y ≥ 3.0 and H-Y < 3.0 patients.
ModelUnstandardized CoefficientsStandardized CoefficientstP

BStd. ErrorBeta
ABC-0.1750.037- 0.254-4.703<0.001
UPDRS-II score0.6650.1540.2254.310<0.001
Disease duration0.7160.2960.1162.4170.017
Adjusted R20.753
Table 4  Factors associated with QoL in stepwise multiple linear regression model.
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