Non-Motor Symptoms and Associated Factors in Parkinson's Disease Patients in Addis Ababa, Ethiopia: A Multicenter Cross-Sectional Study

Frequency and Factors Associated with Orthostatic Hypotension in Individuals with Parkinson's Disease: A Case-Control Observational Study

Background

Orthostatic hypotension (OH) is a common and considered the most incapacitating non-motor symptom of Parkinson's disease (PD). Little is known about OH in Ethiopian PD patients. The objectives of the present study were to determine the frequency and factors associated with OH in individuals diagnosed with PD compared to a healthy control.

Methods

A multi-center case-control observational study was conducted. A total of 53 PD cases and 53 age and sex matched healthy controls were included. Both descriptive and Chi-square proportional statistical analysis were used.

Results

The mean age distribution was comparable between the two study groups (61.9 vs. 59.9 years). Distribution of male gender was comparable between PD and control groups (71.7% vs. 67.9%). Nearly all the individuals diagnosed with PD were on levodopa treatment, and close to half of them were on anticholinergic drugs. Hypertension was the commonest comorbid disorder in both groups. The prevalence of orthostatic hypotension was higher in PD patients (22.6%) compared to the control group (9.4%). The proportion of constipation (p=0.007), urinary urgency (p=0.007), and nocturia (p<0.0001) was significantly higher among Parkinson's disease patients compared to the healthy control group. Falls and excessive sweating were only reported by PD patients.

Conclusion

The present study shows the frequency of orthostatic hypotension in Ethiopian Parkinson's disease patients is comparable to other regions. The presence of constipation, urinary urgency, and nocturia was associated with Parkinson's disease compared to the control group.

The prevalence and associated factors of dysphagia in Parkinson's disease: A systematic review and meta-analysis

Background

The prevalence and associated factors of dysphagia in Parkinson's disease (PD) are different in studies conducted in different countries. The purpose of our systematic review and meta-analysis was to evaluate the prevalence of dysphagia in PD and to clarify its associated factors.

Methods

Two researchers systematically searched PubMed, Embase, Web of Science, Cochrane Library, CNKI, Wanfang Database, SinoMed and VIP databases and manually searched references in the retrieved articles to identify potential research subjects. The last search was conducted on June 28, 2022. Finally, a total of 58 studies including 60 observations with 20,530 PD patients were included in our meta-analysis.

Results

The meta-analysis estimated that the pooled prevalence rate of dysphagia in PD was 36.9% (95% CI: 30.7–43.6%) and instrumental examination showed a higher prevalence (57.3%, 95% CI: 44.3–69.1%). Oceania showed the highest prevalence of dysphagia in PD (56.3%) compared to Africa (39.5%), Asia (38.6%), Europe (36.1%) and America (28.9%). Dysphagia in PD was associated with older age, lower body mass index, longer disease duration, higher Hoehn and Yahr stage and levodopa equivalent daily dose, PIGD subtype, severe motor symptoms, drooling and higher levels of depression, and lower quality of life.

Conclusions

In conclusion, our meta-analysis showed that dysphagia occurs in more than one-third of PD patients and was associated with several demographic characteristics and PD-related characteristics, motor symptoms, non-motor symptoms, as well as decreased quality of life. It deserves early screening, diagnosis, and treatment in clinical practice to prevent serious complications from dysphagia.

Factors Associated with EEG Slowing in Individuals with Parkinson's Disease

Background

A plethora of scientific studies has shown diffuse slowing on electroencephalograph (EEG) study is a frequent occurrence in Parkinson's disease (PD) patients, compared to the healthy controls. Little is known about EEG slowing and PD in the sub-Saharan Africa, especially in Ethiopia. The objective of this study was to assess factors associated with EEG slowing in individuals with Parkinson's disease.

Method

A cross-sectional observational study was conducted in 40 PD patients at Yehuleshet Specialty Clinic, Addis Ababa, Ethiopia. Both descriptive and analytical statistics were used to analyze the data.

Results

Total of 40 patients with PD was included in the present survey. The median age was 66 (IQR: 52.5 – 72.5 years) and young onset PD accounted 20%. Males accounted for twothird of the participants. Diffuse EEG slowing was observed in 52.5% (n=21) of participants. Majority (85%) were on levodopa treatment. Hypovitaminosis D was observed in 93.1% of the study participants. White matter hyperintensity (WMH) and global brain atrophy were seen in 47.5% and 27.5% respectively. Even though statistically not significant, PD patients with EEG slowing, reported more forgetfulness and had WMH on their brain MRI, compared to those with normal EEG. Age was associated with diffuse EEG slowing when adjusted for forgetfulness and WMH (Adjusted OR 1.18 95% CI (1.01 – 1.37) p=0.03).

Conclusion

The present study indicates high prevalence of diffuse EEG slowing in PD patients. Age was associated with diffuse EEG slowing. Higher proportion of patients with EEG slowing reported forgetfulness and hypovitaminosis D compared to those with normal EEG recordings.