[A study made on a data base of 2,471 patients with Parkinson disease and disorders of movement in Health District 1 of the autonomous region of Madrid. Observed demographic changes over 8 year-period].

INTRODUCTION

A specialised unit may influence favourably primary levels of health system by alerting physicians and patients on the existence of those pathologies most commonly seen.

OBJECTIVES

To determine demographic changes and referral patterns observed in a hospital-based monographic outpatient clinic on Parkinson's disease and movement disorders along an eight-year period (1991-1998).

PATIENTS AND

METHODS

Database analysis of 2,471 patients attending a specialised unit covering an urban and rural population of 630,000 people in South-East Madrid city and county.

RESULTS

We observed a slight, albeit non-significant reduction in the incidence of secondary parkinsonisms (40% of all parkinsonisms observed). This occurred despite a drastic reduction in drug-induced parkinsonisms, particularly those caused by cinnarizine/flunarizine and flupentixol. The reduction was balanced by a relative increase in neurodegenerative parkinsonisms, particularly Lewy body dementia. There was a sustained decrease in the time elapsed between onset of symptoms and identification of parkinsonisms as well as identification of its primary or symptomatic nature. The incidence of tardive dystonia (46.7%) of all symptomatic dystonias) remained unchanged. Essential tremor referrals markedly increased along the study period.

CONCLUSIONS

Demographics features of patients attending a Parkinson's disease and movement disorder unit are submitted to changes over time. These probably reflect better awareness about these conditions by patients and physicians, ready access to hospital-based specialised units, and a greater demand for specialised care by the aged.