Objective: To establish the prevalence and demographical characteristics of patients seen in a Movement Disorders (MD) Centre.

Background: Movement disorders contribute to a significant proportion of the neurologic disease burden worldwide. The Parkinson’s Disease and Movement Disorder (PDMD) clinic at our tertiary hospital, run by 3-4 specialists at any one period, is a major referral centre for movement disorders in Singapore. This is a 15-year review of our database of consecutive patients seen at our clinic since 2002.

Methods: We recruited all patients seen at our PDMD clinic for the period of 2002-2017. Demographic data, clinical symptoms, diagnoses and co-morbidities were captured at all available visits up to the point of data entry. Most patients had data entered after the first visit. Comparisons between three 5-year intervals, 2002 – 2007, 2007 – 2012 and 2012 – 2017 were made to establish trends.

Results: Since 2002, 8181 patients were seen at the PDMD clinic, 5848 of whom received incident diagnoses. The three most common newly diagnosed conditions were parkinsonism (3470), tremor disorder (1096) and hemifacial spasm (529) accounting for 59.3%, 18.7% and 9.0% of the database. 53 patients had 2 diagnoses. Mean age at diagnosis was 66.9 for parkinsonism, 51.4 for tremor disorder and 53.7 for hemifacial spasm (56.7%, 56.3% and 40.5% males respectively). The top diagnoses in patients with parkinsonism were PD (2461), vascular parkinsonism (200), multiple systems atrophy (195) and progressive supranuclear gaze palsy (177). Essential tremor (872), enhanced physiological tremor (144) and functional tremor (50) accounted for the majority for tremor disorders. The number of incident cases of parkinsonism increased over the three periods (920 in 2002-2007, 1230 in 2007-2012, and 1320 in 2012-2017). In the parkinsonism group, median Hoehn and Yahr (H&Y) scores at first visit were compared across periods. Median H&Y scores for the first, second and third periods were 2.75 (n = 25), 2.94 (n = 86) and 2.45 (n = 793) respectively. Compared to 2007-2012, parkinsonian patients presented at earlier stage of disease in the period of 2012-2017 (post-hoc Mann-Whitney U analysis, U=24961.5, p=<.001).

Conclusions: The observed variation in incidence in our large database over different time periods is likely attributable to increased public awareness of movement disorders, in particular PD, as well as an ageing population. With changing demographics, a regular review of the database is important to estimate disease burden and anticipate healthcare resource needs.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/a-15-year-review-of-a-movement-disorder-database-in-singapore/