Clinical features at first visit and rapid disease progression in Parkinson's disease

We report a retrospective multivariable analysis of the association between patient characteristics at first clinic visit and rapid disease progression in 1411 Parkinson's disease patients treated between 1985 and 2006. At first visit rapid progression was positively associated with age at onset ≥ 70 years (OR = 5.77), rigidity (OR = 1.94), bradykinesia (OR = 1.73), dementia (OR = 2.61), and levodopa use (OR = 1.74). Rapid progression was negatively associated with disease duration (OR = 0.52), male sex (OR = 0.49), and resting tremor at first visit (OR = 0.44). Family history of movement disorders, while significant for univariable analysis, did not retain significance in multivariable analysis. This initial clinical profile may aid physicians in adjusting treatment and follow-up plans. Further prospective studies are needed to evaluate this relationship.