Objective: To evaluate the difference of motor and non-motor dysfunction, and quality of life in Parkinson’s disease (PD) patients with and without delayed diagnosis.

Background: Parkinson’s disease is a disorder with an average time to diagnosis of 12 months [1]. In Mexico, the mean delay in diagnosis is 29 months, 2.5 times higher than other countries [2]. Factors associated are male gender; motor symptoms onset <40 years old; having a first-degree relative with PD; among others [3]. Otherwise, there are factors that increase mortality, such as older age at diagnosis, male gender, disease duration, higher baseline clinimetric scores [4,5]. This could be explained by a delayed diagnosis.

Method: 70 Mexican PwP selected randomly were included in this retrospective study. Delay in the PD diagnosis was assessed by the difference between the year of symptoms onset reported by the patient and the year of PD diagnosis. Mann-Whitney U test for two groups (delayed diagnosis with a cutoff point of 12 months) was used to establish the clinical total differences in the baseline assessment and a follow-up of: (i) motor dysfunction (Hoehn&Yahr stage, Unified Parkinson’s Disease Rating Scale [UPDRS]); (ii) non-motor dysfunction (Non-Motor Rating Scale [NMSS]); and (iii) impact on QoL (8-item Parkinson’s Disease Questionnaire index [8-PDQi]).

Results: We selected 37 men and 33 women; the mean age at onset symptoms and at diagnosis were 58 ±12.9 and 60 ±13.3 years old. 60% had delayed diagnosis, with a mean of 1.77 years ±2.78.  Mean duration of disease was 9.2 years ± 5.2; with no significant difference between both groups (p=0.344). The follow-up was 495.2± 179.6 days after the baseline evaluation. Difference in total scores between evaluations was calculated and then Mann-Whitney U test showed no significant difference between both groups (UPDRS, p=0.557; NMSS, p=0.990; 8-PDQi, p=0.909; H&Y, p=0.146).

Conclusion: There isn’t a quantitative difference in clinimetric scores between patients with and without delayed diagnosis. This could be explained by the short time between the two evaluations. Further analysis is needed, to continue evaluating the progress of PD in patients with delayed diagnosis to identify if there is a difference in the long term that might affect PwP prognosis. Other variables could provide more information, such as cognitive dysfunction, or motor and non-motor fluctuations.

References: [1] Breen DP, Evans JR, Farrell K,et al. Determinants of delayed diagnosis in Parkinson’s disease. Journal of Neurology. 2013;260(8):1978–81.
[2] Cervantes-Arriaga A, Rodríguez-Violante M, Camacho-Ordóñez A, et al. Tiempo desde el inicio de los síntomas motores hasta el diagnóstico de enfermedad de Parkinson en México. Gac Med Mex. 2014;150:242-47.
[3] Parra-Medina LE, Arankowsky-Sandoval G, Salazar-Ceballos JE et al. Latencia diagnóstica en la enfermedad de Parkinson y su relación con los síntomas prodrómicos motores y no motores. 2019.
[4] Oosterveld LP, Allen JC, Reinoso G, et al. Prognostic factors for early mortality in Parkinson’s disease. Parkinsonism & Related Disorders. 2015;21(3): 226–30.
[5] Okunoye O, Horsfall L, Marston L, et al. Mortality of People with Parkinson’s Disease in a Large UK‐Based Cohort Study: Time Trends and Relationship to Disease Duration. Mov Disord. 2021.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-the-delayed-diagnosis-in-the-prognosis-of-parkinsons-disease/