Dr Carl Counsell
University of Aberdeen
Characterisation of the long-term prognosis of Parkinson's and development of statistical models to predict prognosis
Many aspects of prognosis in Parkinson’s are unclear, including to what degree mortality is increased and which factors influence prognosis. There are no prognostic models available in Parkinson’s. Improved understanding of prognosis and in particular the development of prognostic models has important clinical and research benefits. The optimal way to obtain such prognostic data is long-term follow-up of community-based incident cohorts.
1. To perform systematic reviews of mortality and disability in Parkinson’s
2. To identify factors that influence prognosis in an incident cohort
3. To develop prognostic models in Parkinson’s
Methods: We will perform systematic reviews of previous studies of mortality and disability in PD and metaanalyses where possible to put our new data into context. We will provide new data on the long-term prognosis of Parkinson’s by further follow-up of an existing representative community-based incident cohort of 212 patients with Parkinson’s, their carers and 266 matched controls. Data on multiple outcomes including mortality, impairment, motor and non-motor complications, disability and quality of life and carer burden are collected annually. We will describe patient and carer prognosis in terms of these outcomes. We will then extend previous work about which factors influence specific outcomes (survival, impairment, dependency in activities of daily living and quality of life) using multivariate regression analyses or Cox proportional hazards modelling and, with judicious selection of variables, develop prognostic models to predict survival and death or dependency. We will perform internal validation and, if possible, external validation in another cohort.