Parkinson's disease patients in institutionalized care

Background: The objective of this study was to assess the prevalence and causes of institutionalization of patients with Parkinson's disease (PD) in the city of Turku, Finland. We also analysed the severity of motor, cognitive and ADL functions in residents with PD. Methods: All the residents with a diagnosis of PD, living in the long-term care facilities in the city of Turku were identified. A total of 33 residents were examined clinically and their medical records were checked. Only the 22 residents who fulfilled the United Kingdom Parkinson's Disease Brain Bank Criteria were enrolled into the study. Results: There were 1228 residents living in the long-term care facilities in the study area; consequently, 1.8% of the residents had PD. The median age of the residents with PD was 81 years (range 69-91) and the median duration of their disease was 8 years (3-25). The principal causes for institutionalization were severe motor and cognitive impairments and the presence of a debilitating concomitant disorder. Before institutionalization, 19 out of the 22 residents had already needed daily help in many activities of daily living. All the residents with PD in long-term care were receiving levodopa and nearly half of them were experiencing fluctuations in motor function. During 3 years of follow-up, 15 of the 22 residents had died. The median duration of long-term care of the deceased residents was 34 months and the median age at death was 83 years (70-93). Conclusions: Long-term care facility residents with PD suffer from severe motor, cognitive and ADL impairments. (C) 2013 Elsevier Masson SAS and European Union Geriatric Medicine Society. All rights reserved.