Objective: To determine the association between clinical stage of Parkinson’s disease (PD), according to the Hoehn & Yahr (H&Y) scale, and the severity of non-motor symptoms assessed by the MDS-UPDRS Part I in patients treated in Lima during 2025.

Background: Non-motor symptoms significantly impact quality of life in PD patients. Although their prevalence is recognized, the relationship between clinical progression and non-motor symptom severity remains underexplored, particularly in Latin American populations.

Method: An observational, analytical cross-sectional study was conducted in 92 patients with confirmed PD in Lima, Peru (2025). Clinical stage was categorized as early (H&Y 1–2), intermediate (H&Y 3), and advanced (H&Y 4–5). Non-motor symptom severity was assessed using the MDS-UPDRS Part I and categorized as mild, moderate, or severe. Descriptive, bivariate, and multivariate analyses were performed. Ordinal logistic regression estimated crude and adjusted odds ratios (OR) with 95% confidence intervals (CI). Variables with p<0.20 in bivariate analysis were included in the multivariate model.

Results: The population was predominantly male (67.4%), aged 41–64 years (43.5%), with a disease duration of 6–10 years (46.7%). H&Y stage 3 was most frequent (34.8%). Moderate non-motor symptom severity was most prevalent (58.7%). A statistically significant association was found between clinical stage and non-motor symptom severity (p<0.001), with progressive increase in severe symptom proportion as disease stage advanced. In multivariate analysis, H&Y clinical stage was identified as the main factor associated with non-motor symptom severity. Compared to early stage, intermediate stage showed OR=5.79 (95% CI: 1.86–18.02, p=0.03) and advanced stage showed OR=26.02 (95% CI: 6.83–99.16, p<0.01) for higher non-motor symptom severity. Age, sex, and disease duration showed no significant association.

Conclusion: Clinical stage according to the Hoehn & Yahr scale constitutes a key predictor of non-motor symptom severity in Parkinson’s disease. These findings highlight the importance of comprehensive non-motor symptom assessment throughout disease progression, particularly in advanced stages.

References: Onder H, Comoglu S. Investigation of nonmotor symptoms and their clinical correlates in patients with Parkinson’s disease. Neurodegener Dis Manag. 2025 Feb;15(1):47–55. doi:10.1080/17582024.2025.2468145. PMID:40091819.

Anis S, et al. Differences and contributors to global cognitive performance in Parkinson’s disease. J Int Neuropsychol Soc. 2025; (artículo con DOI: 10.1080/13854046.2025.2450020).

Rodríguez-Blázquez C, Schrag A, Rizos A, Chaudhuri KR, Martinez-Martin P, Weintraub D. Prevalence of non-motor symptoms and non-motor fluctuations in Parkinson’s disease using the MDS-NMS. Mov Disord Clin Pract. 2020;8(2):231-239. doi:10.1002/mdc3.13122.

Custodio N, Alva-Díaz C, Morán-Mariños C, Mejía-Rojas K, Lira D, Montesinos R, et al. Factors associated with depression in patients with Parkinson’s disease: a multicenter study in Lima, Peru. Dement Neuropsychol. 2018;12(3):292-298. DOI:10.1590/1980-57642018dn12-030010.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinical-stage-according-to-hoehn-yahr-scale-as-a-predictor-of-non-motor-symptom-severity-in-parkinsons-disease-a-cross-sectional-in-peru/