We previously assessed the prevalence and risks of motor/nonmotor symptoms in a large sample of Japanese patients with Parkinson’s disease. In the present study, we longitudinally assessed the prevalence and risk of motor/nonmotor symptoms, changes in treatment, disease progression, and death in patients with Parkinson’s disease. We enrolled 1,227 patients diagnosed and treated at our hospital in Tokyo at first evaluation. We were able to follow-up 445 patients until the second evaluation, 7.4 years later. Using Kaplan–Meier survival curves and the Cox proportional-hazards model in 1,227 patients, motor/nonmotor symptoms were analyzed in association with the following events: pain, wearing-off, camptocormia, psychosis, orthostatic hypotension, pneumonia, tube feeding, modified Hoehn and Yahr stages (H–Y) 3 and 4 of the on state, and death. The mean age (standard deviation) at the first evaluation was 67.2 (9.9) years, while the mean ages at onset and disease duration were 57.8 (11.7) years and 9.3 (6.6) years, respectively. The mean H–Y of the on state was 2.7 (1.1) at the first evaluation. Age at onset and duration of levodopa use decreased the hazard ratios (HRs) (0.968 and 0.910, respectively) for wearing-off. Female sex increased the HRs (1.414) for wearing-off and decreased the HRs for orthostatic hypotension (0.540) and pneumonia (0.510). Older age at onset increased the HR for psychosis (1.035), orthostatic hypotension (1.033), H–Y 3 (1.048) and 4 (1.071), pneumonia (1.123), tube feeding (1.140), and death (1.095). Early onset of orthostatic hypotension itself increased the HR for numerous events, especially for death (0.893). Our results indicated that age, sex, and some nonmotor symptoms may predict many Parkinson’s disease-related events. In addition, these data may provide a useful reference for the clinical course of Parkinson’s disease.

中文翻译：

---

帕金森氏病患者的运动/非运动症状和进展：一项纵向研究的患病率和风险。

我们先前评估了日本帕金森氏病患者的大量样本中运动/非运动症状的患病率和风险。在本研究中，我们纵向评估了帕金森氏病患者的运动/非运动症状，治疗改变，疾病进展和死亡的发生率和风险。首次评估时，我们招募了1,227名在东京医院诊断和治疗的患者。我们能够随访445例患者，直到7.4年后进行第二次评估。使用Kaplan–Meier生存曲线和Cox比例风险模型对1,227例患者进行运动/非运动症状与以下事件的相关分析：疼痛，疲倦，坎普克皮毛病，精神病，体位性低血压，肺炎，管饲，改良的Hoehn和Yahr阶段（H–Y）的第3和第4阶段以及死亡。首次评估的平均年龄（标准差）为67.2（9.9）岁，而发病的平均年龄和疾病持续时间分别为57.8（11.7）岁和9.3（6.6）岁。第一次评估时，接通状态的平均HY为2.7（1.1）。左旋多巴的发作年龄和持续时间降低了穿破的危险比（HRs）（分别为0.968和0.910）。女性性别会增加穿用的心率（1.414），而体位性低血压（0.540）和肺炎的心率会降低（0.510）。老年发作会增加精神病的HR（1.035），体位性低血压（1.033），H-Y 3（1.048）和4（1.071），肺炎（1.123），管饲（1.140）和死亡（1.095）。体位性低血压的早期发作本身就增加了许多事件的HR，尤其是对于死亡（0.893）。我们的结果表明，年龄，性别，一些非运动性症状可能预示着许多帕金森氏病相关事件。此外，这些数据可能为帕金森氏病的临床病程提供有用的参考。