Parkinson’s disease shows a heterogeneous course and different clinical subtyping systems have been described. To compare the capabilities of two clinical classification systems, motor-phenotypes, and a simplified clinical motor-nonmotor subtyping system, a cohort was included at mean 7.9 ± 5.3 years of disease duration, classified using both clinical systems, and reexamined and reclassified at the end of an observation period. Time-points were retrospectively extracted for five major disease milestones: death, dementia, Hoehn and Yahr stage 5, nursing home living, and walking aid use. Eighty-nine patients were observed for 8.1 ± 2.7 years after inclusion. Dementia developed in 32.9% of the patients and 36.0–67.4% reached the other milestones. Motor-phenotypes were unable to stratify risks during this period, but the worst compared with the more favorable groups in the motor-nonmotor system conveyed hazard ratios between 2.6 and 63.6 for all milestones. A clear separation of risks for dying, living at the nursing home, and reaching motor end-stage was also shown when using only postural instability and gait disorder symptoms, without weighing them against the severity of the tremor. At reexamination, 29.4% and 64.7% of patients had changed classification groups in the motor-phenotype and motor-nonmotor systems, respectively. The motor-nonmotor system thus stratified risks of reaching crucial outcomes in mid–late Parkinson’s disease far better than the well-studied motor-phenotypes. Removing the tremor aspect of motor-phenotypes clearly improved this system, however. Classifications in both systems became unstable over time. The simplification of the motor-nonmotor system was easily applicable and showed potential as a prognostic marker during a large part of Parkinson’s disease.

帕金森病表现出异质性病程，并且已经描述了不同的临床亚型系统。为了比较两种临床分类系统、运动表型和简化的临床运动-非运动亚型系统的能力，包括一个平均 7.9 ± 5.3 年病程的队列，使用两种临床系统进行分类，并在观察期结束。回顾性提取了五个主要疾病里程碑的时间点：死亡、痴呆、Hoehn 和 Yahr 5 级、疗养院生活和助行器使用。89 名患者在纳入后观察了 8.1 ± 2.7 年。32.9% 的患者出现痴呆症，36.0-67.4% 的患者达到了其他里程碑。在此期间，运动表型无法对风险进行分层，但与运动-非运动系统中更有利的组相比，最差的组的所有里程碑的风险比都在 2.6 到 63.6 之间。当仅使用姿势不稳定和步态障碍症状时，也显示了死亡、住在疗养院和达到运动终末期的风险的明确分离，而没有将它们与震颤的严重程度进行权衡。在复查时，分别有 29.4% 和 64.7% 的患者改变了运动-表型和运动-非运动系统的分类组。因此，运动-非运动系统对中晚期帕金森病达到关键结果的风险进行了分层，远优于经过充分研究的运动表型。然而，去除运动表型的震颤方面显然改善了这个系统。随着时间的推移，两个系统中的分类都变得不稳定。