Heart Diseases/epidemiology* ; Humans ; Parkinson Disease/drug therapy* ; Propolis

Oro-pharyngeal dysphagia is a common symptom in patients with Parkinson's disease (PD) and related disorders, even in their early stage of diseases. Dysphagia in these patients has been underdiagnosed, probably due to poor the self-awareness of the conditions and the underuse of validated tools and objective instruments for assessment. The early detection and intervention of dysphagia are closely related to improving the quality of life and decreasing the mortality rate in these patients. The purpose of this paper is to give an overview of the characteristics of dysphagia, including the epidemiology, pathophysiology, and clinical symptomatology, in patients with PD compared with other parkinsonian disorders and movement disorders. The management of dysphagia and future research directions related to these disorders are also discussed.
Deglutition Disorders ; Dystonia ; Epidemiology ; Humans ; Mortality ; Movement Disorders ; Parkinson Disease ; Parkinsonian Disorders ; Quality of Life

OBJECTIVE: To determine the prevalence of osteoporosis (OP) and osteoporotic vertebral fracture (OVF) in people with Parkinson’s disease (PD) in Korea and its association with socioeconomic status.METHODS: Using Health Insurance Review and Assessment Service-National Inpatient Sample (HIRA-NIS) data from 2009 to 2013, we estimated the annual prevalence of PD, OP, and OVF and investigated its association with socioeconomic status using data from National Health Insurance (NHI) beneficiaries and Medical Aid (MA) recipients. This study was supported by research funding from Korean Society for Bone and Mineral Research 2015. There were no study-specific biases related to conflicts of interest.RESULTS: The number of PD patients in the HIRA-NIS increased each year from 2009 to 2013. Among patients with PD, the standardized prevalence rates of OP and OVF increased from 2009 to 2013; from 23.2 to 27.8 and from 2.8 to 4.2, respectively. Among patients with PD with OP, the prevalence of OVF were 12.2% and 15.1% in 2009 and 2013, respectively. The standardized prevalence rates of PD with OP and PD with OVF were significantly higher in MA recipients than in NHI beneficiaries.CONCLUSION: The prevalence of PD both with OP and with OVF increased and the prevalence was higher in MA recipients than in NHI beneficiaries. These findings may suggest that age over 65 years, female and low income may be a significant factor related to PD occurring with OP and OVF.
Bias (Epidemiology) ; Cross-Sectional Studies ; Female ; Financial Management ; Fractures, Bone ; Humans ; Inpatients ; Insurance, Health ; Korea ; Miners ; National Health Programs ; Osteoporosis ; Parkinson Disease ; Prevalence ; Risk Factors ; Social Class

A low prevalence of Parkinson's disease (PD) has been reported in the Sub-Saharan Africa (SSA) region. The genetic causes and clinical features of PD in this region have been poorly described. Very few reports have examined the availability and access to evidence-based quality care for people living with PD in this region. We reviewed all publications focusing on idiopathic PD from SSA published up to May 2016 and observed a prevalence of PD ranging from 7/100,000 in Ethiopia to 67/100,000 in Nigeria. The most recent community-based study reported a mean age at onset of 69.4 years. The infrequent occurrence of mutations in established PD genes was also observed in the region. Treatments were non-existent or at best irregular. Additionally, there is a lack of well-trained medical personnel and multidisciplinary teams in most countries in this region. Drugs for treating PD are either not available or unaffordable. Large-scale genetic and epidemiological studies are therefore needed in SSA to provide further insights into the roles of genetics and other etiological factors in the pathogenesis of PD. The quality of care also requires urgent improvement to meet the basic level of care required by PD patients.
Africa South of the Sahara ; Age of Onset ; Epidemiologic Studies ; Epidemiology ; Ethiopia ; Genetics ; Humans ; Nigeria ; Parkinson Disease ; Prevalence

Rapid eye movement (REM) sleep behavior disorder (RBD) is a parasomnia characterized by sleep interruption or trauma due to abnormal behaviors that occur during REM sleep. The pathophysiology of RBD is known to be a dysfunction of brainstem circuit that causes the loss of skeletal muscle atonia during REM sleep. The diagnosis of RBD is needed to confirm REM sleep without atonia in the polysomnography. The management of RBD includes not only drug treatment, but also to prevent injury from RBD and to follow-up on neurodegenerative diseases that may occur later. RBD is thought to be a prodromal stage of neurodegenerative disease associated with α-synucleoinopathy, such as Parkinson's Disease or multiple system atrophy. This article reviews the symptoms, epidemiology, diagnosis and treatment of RBD, the relevance of neurodegenerative diseases, and recent research trends.
Brain Stem ; Diagnosis ; Epidemiology ; Follow-Up Studies ; Multiple System Atrophy ; Muscle, Skeletal ; Neurodegenerative Diseases ; Parasomnias ; Parkinson Disease ; Polysomnography ; Prodromal Symptoms ; REM Sleep Behavior Disorder ; Sleep, REM

Following the implementation of a long-term care insurance system for the elderly in Korea, many nursing homes have been established and many more patients than ever before have been living at nursing homes. Despite the fact that this is a high-risk group vulnerable to hip fractures, no study has yet been conducted in Korea on hip fracture incidence rates and prognoses among patients residing at nursing homes. We recently studied 46 cases of hip fracture in nursing homes; more specifically, we investigated the most common conditions under which fractures occur, and examined the degree of recovery of ambulatory ability and the mortality within 1 yr. Among those who had survived after 1 yr, the number of non-functional ambulators increased from 8 hips before hip fracture to 19 hips at final post-fracture follow-up. These individuals showed poor recovery of ambulatory ability, and the number who died within one year was 11 (23.9%), a rate not significantly different from that among community-dwelling individuals. It was evident that hip-joint-fracture nursing home residents survived for similar periods of time as did those dwelling in the community, though under much more uncomfortable conditions. The main highlight of this report is that it is the first from Korea on nursing home residents' ambulatory recovery and one-year mortality after hip fracture. The authors believe that, beginning with the present study, the government should collect and evaluate the number of hips fractured at nursing facilities in order to formulate criteria that will help to enable all patients to select safer and better-quality nursing facilities for themselves or their family members.
Aged ; Aged, 80 and over ; Body Mass Index ; Cerebrovascular Disorders/etiology ; Dementia/etiology ; Female ; Hip Fractures/complications/*epidemiology/mortality ; Humans ; Insurance, Long-Term Care ; Kaplan-Meier Estimate ; Male ; Nursing Homes ; Odds Ratio ; Parkinson Disease/etiology ; Republic of Korea/epidemiology ; Risk Factors

OBJECTIVETo screening mutations of exons 15, 18 and 26 of sodium channel Nav1.7 (SCN9A) gene, and to assess its association with pain related to Parkinsonism.

METHODSRespectively, 101 patients with primary Parkinson's disease (PD) and 104 similar-aged volunteers without PD were recruited from March, 2008 to January, 2011. Mutations of above 3 exons in SCN9A gene was detected with PCR and direct sequencing. For 100 patients with Parkinsonism, the pain was scored with a McGill pain rating scale. Statistical analysis was performed with SPSS.

RESULTSThe prevalence of pain in Parkinsonian was 57%. 43.86% patients with pain were males, and 56.14% were females. Based on Chaudhuri criteria, the pain symptoms may be classified as musculoskeletal pain (10.52%), radicular pain (10.52%), dyskinesis pain (54.38%), pain from akathisia and restlessness (14.04%), dyskinesis combined with radicular pain (5.26%), skeletal muscles pain and headache (1.75%), and arthralgia (3.50%). Two missense mutations were identified, which included 2794A/C (0.941/0.059) (rs12478318) (M932L) in exon 15 and 3448C/T (0.988/0.012) (rs6746030) (R1150W) in exon 18. The wild type A/C for the 2794 locus had a higher prevalence in PD patients with pain, but this was not statistically different. All of the 5 heterozygotes for 3448 (C/T) were found in Parkinsonian patients with pain. No homozygotes were found.

CONCLUSIONThe prevalence of pain was higher in Parkinsonian patients than general population, and the proportion of males to females was similar. More patients have suffered dyskinesis pain. A 3448 (C/T) mutation of SCN9A gene may be related to pathogenesis of pain in Parkinsonism.

Adult ; Aged ; Aged, 80 and over ; Alleles ; Base Sequence ; Exons ; Female ; Gene Frequency ; Genotype ; Humans ; Male ; Middle Aged ; Mutation ; NAV1.7 Voltage-Gated Sodium Channel ; genetics ; Pain ; epidemiology ; etiology ; Parkinson Disease ; complications ; genetics ; Prevalence

Exposure to manganese (Mn) is associated with neurobehavioral effects. There is disagreement on whether commonly occurring exposures in welding, ferroalloy, and other industrial processes produce neurologically significant neurobehavioral changes representing parkinsonism. A review of methodological issues in the human epidemiological literature on Mn identified: (1) studies focused on idiopathic Parkinson disease without considering manganism, a parkinsonian syndrome; (2) studies with healthy worker effect bias; (3) studies with problematic statistical modeling; and (4) studies arising from case series derived from litigation. Investigations with adequate study design and exposure assessment revealed consistent neurobehavioral effects and attributable subclinical and clinical signs and symptoms of impairment. Twenty-eight studies show an exposure-response relationship between Mn and neurobehavioral effects, including 11 with continuous exposure metrics and six with three or four levels of contrasted exposure. The effects of sustained low-concentration exposures to Mn are consistent with the manifestations of early manganism, i.e., consistent with parkinsonism. This is compelling evidence that Mn is a neurotoxic chemical and there is good evidence that Mn exposures far below the current US standard of 5.0 mg/m3 are causing impairment.
Bias (Epidemiology) ; Healthy Worker Effect ; Humans ; Jurisprudence ; Manganese* ; Models, Statistical ; Neurobehavioral Manifestations ; Neuropsychological Tests ; Occupations* ; Parkinson Disease ; Parkinsonian Disorders* ; Welding

OBJECTIVE: To evaluate the swallowing function and the incidence of swallowing dysfunction in the elderly, and study the effect of age on swallowing function. METHOD: A total of 1040 (age > or = 55 years) elderly-to-be and elderly who undertaken the health examination in health examination center of our hospital from March 16, 2012 to April 9, 2012 were included in this study. The incidence of swallowing dysfunction in the elderly and the effect of age on swallowing function were evaluated. The subjects with stroke, esophageal cancer, parkinson's disease, deglutition syncope, esophageal spasm, thyrohyoid cyst and so on were defined as basic disease group, the other as normal group. The incidence of swallowing dysfunction was compared between the two groups. RESULT: The incidences of swallowing dysfunction in basic disease group and normal group were 74.4% (29/39) and 5.5% (55/1001), and there was a significant difference between the two groups (P < 0.001). The swallowing dysfunction rates of elderly-to-be and elderly in normal group were 2.9% (9/311) and 6.7/% (46/690) and the difference between the two groups was significant (P < 0.05). With the growth of age, the swallowing dysfunction rate in different age group increased, and the number of rapid swallow in 30 s decreased gradually (P < 0. 001). CONCLUSION Stroke, esophageal cancer, Parkinson's disease and so on are the main causes of swallowing dysfunction in elderly. The swallowing dysfunction rate is 6.7% in the normal elderly. With the growth of age, the incidence of swallowing dysfunction is increased and the swallowing speed is decreased.
Age Factors ; Aged ; Aged, 80 and over ; Case-Control Studies ; Deglutition ; physiology ; Deglutition Disorders ; epidemiology ; physiopathology ; Female ; Humans ; Incidence ; Male ; Middle Aged ; Parkinson Disease ; physiopathology ; Stroke ; physiopathology

The recent identification of a common genetic variant (LRRK2 G2385R) which is associated with a two-fold increased risk of sporadic Parkinson's Disease (PD) in two independent Chinese populations in Singapore and Taiwan has generated considerable excitement. Thus far, this variant appears specific for the Asian population, emphasising further that ethnic-specific effects should be considered in genetic association studies. Cautious optimism is advised as we await more scientific studies and clarification if this risk variant is specific to ethnic Chinese race. Our in-vitro studies suggest the Gly2385Arg variant is biologically relevant and it might act through pro-apoptotic mechanisms, especially under cellular stresses. This may provide a partial explanation why some carriers develop the disease while others do not. The presence of other epigenetic factors, gene-gene and gene-environmental interaction could modulate the phenotype expression. Further validation of these findings would be needed to confirm this variant as the single most important common genetic risk factor in ethnic Chinese and/or Asian PD patients. The identification of the LRRK2 Gly2385Arg variant could potentially facilitate the development of clinical, bioimaging, genetic and biological biomarkers, useful in the monitoring and neuroprotective therapy in asymptomatic individuals.
Asian Continental Ancestry Group ; Biomarkers ; DNA ; genetics ; Genetic Predisposition to Disease ; Humans ; Leucine-Rich Repeat Serine-Threonine Protein Kinase-2 ; Mutation ; Parkinson Disease ; ethnology ; genetics ; Prevalence ; Protein-Serine-Threonine Kinases ; genetics ; Risk Factors ; Singapore ; epidemiology ; Taiwan ; epidemiology