EFFECTS OF VASCULAR COMORBIDITY IN PARKINSON'S DISEASE. Issue 12 (15th November 2016) - Swallow, Diane M A
Abstract : Vascular disease and risk factors are common in Parkinson's disease (PD) and may influence phenotype. Statin therapy may thus be indicated. 1759 recently diagnosed PD cases from a multicentre prospective study underwent a Montreal Cognitive Assessment and the Unified PD Rating Scale part 3 (UPDRS 3). History of vascular events, risk factors and statin usage was recorded. QRISK2 quantified cardiovascular risk. Mean age was 67.5 (SD 9.3), disease duration 1.3 (SD 0.9) years, 65.2% male. 4.7% had prior stroke/TIA, 12.5% cardiac disease, 30.4% hypertension, 27.3% high cholesterol, 20.7% obesity, 7.2% diabetes and 4.6% smokers. Patients with prior stroke/TIA had more cognitive impairment (42.0% versus 25.0%, p<0.001) and postural instability gait difficulty (p=0.02). 32.6% had QRISK2 ≥20%, 30.2% QRISK2 10–20%, and 22.5% QRISK2 <10%. Age (p<0.001), sex (p<0.001), UPDRS 3 (p<0.001) and cognitive impairment (p=0.019) differences were significant across groups; higher QRISK2 patients were therefore older with worse motor and cognitive status. 77.4% of vascular disease cases were prescribed statins, compared to 37.3% for QRISK2 ≥20%. Vascular comorbidity contributes to disease pattern in PD, and statin usage is suboptimal. This has prognostic and treatment implications.