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Sydney Multicenter Study of Parkinson's disease: non-L-dopa-responsive problems dominate at 15 years
Hely MA, Morris JG, Reid WG, Trafficante R.. Movement disorders : official journal of the Movement Disorder Society, 2005-02-01
Topic: Risk, prevention and care in population studies
One-third of the 149 people recruited 15 to 18 years ago in the Sydney Multicenter Study of Parkinson's disease have survived. The original study compared low-dose levodopa with low-dose bromocriptine. We now report the problems experienced by people who survive 15 years from diagnosis. The standardized mortality ratio is significantly elevated at 1.86 and is not significantly different between treatment arms. Falls occur in 81% of patients, and 23% sustained fractures. Cognitive decline is present in 84%, and 48% fulfill the criteria for dementia. Hallucinations and depression are experienced by 50%. Choking has occurred in 50%, symptomatic postural hypotension in 35%, and urinary incontinence in 41%. No patient is still employed, and 40% of patients live in aged care facilities. Although approximately 95% have experienced L-dopa-induced dyskinesia/dystonia and end of dose failure of medication, in the majority, these symptoms are not disabling. Dyskinesia and dystonia were delayed by early use of bromocriptine, but end-of-dose failure appeared at a similar time once L-dopa was added. The rate of disease progression is similar in both arms of the study. We conclude that the most disabling long-term problems of Parkinson's disease relate to the emergence of symptoms that are not improved by L-dopa. Neuroprotective interventions in Parkinson's disease should be judged by their ability to improve non-L-dopa-responsive aspects of the disease, rather than just by their capacity to delay the introduction of L-dopa or reduce its associated side effects.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Hely, M. A., Morris, J. G., Reid, W. G., & Trafficante, R. (2005). Sydney Multicenter Study of Parkinson's disease: non-L-dopa-responsive problems dominate at 15 years. Movement disorders : official journal of the Movement Disorder Society. https://doi.org/10.1002/mds.20324
Vancouver
Hely MA, Morris JG, Reid WG, Trafficante R. Sydney Multicenter Study of Parkinson's disease: non-L-dopa-responsive problems dominate at 15 years. Movement disorders : official journal of the Movement Disorder Society. 2005. doi:10.1002/mds.20324. PMID: 15551331.
BibTeX
@article{hely2005-15551331,
author = {Hely, M. A. and Morris, J. G. and Reid, W. G. and Trafficante, R.},
title = {{Sydney Multicenter Study of Parkinson's disease: non-L-dopa-responsive problems dominate at 15 years}},
journal = {Movement disorders : official journal of the Movement Disorder Society},
year = {2005},
doi = {10.1002/mds.20324},
pmid = {15551331},
url = {https://doi.org/10.1002/mds.20324}
}
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. Check the citation against the original before you use it.
Key findings
- The standardized mortality ratio is significantly elevated at 1.86 and is not significantly different between treatment arms.
- We conclude that the most disabling long-term problems of Parkinson's disease relate to the emergence of symptoms that are not improved by L-dopa.
Why it matters
In a group of 149 people with Parkinson's disease followed for 15 to 18 years, only about one-third survived; among those survivors, 84% had cognitive decline, 48% met criteria for dementia, 81% had fallen and 40% lived in aged care facilities. The authors conclude that the most disabling long-term problems are symptoms "not improved by L-dopa", and that the drug-related movement problems most survivors had were mostly not disabling. They argue that new treatments meant to slow Parkinson's should be judged by whether they help these problems; the study itself does not test any such treatment.
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Study details
- Participants15
- Evidence strengthLow
How this study scored 52/100
Published in a peer-reviewed journal. Scored zero for study design, effect reported and randomised / blinded because the record does not state it. We have no data on senior author's track record, so that was left out: it earned 50 of the 96 points we could judge it on, which is 52 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Movement disorders : official journal of the Movement Disorder Society) |
| Journal's citation record | 3 / 4 | Movement Disorders: journal h-index 281 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2005 — older than 20 years, still counted |
| Sample size | 1 / 4 | 15 participants |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 3 / 3 | Studied in people (participant count stated) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 7 / 7 | Cited 1,053 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 45.8 citations a year over 23 year(s) since 2005 |
| Impact for its field and year | 4 / 6 | Cited 12.3× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 3 / 6 | Cited by 17 other studies in this library |
| Still being cited | 3 / 4 | Cited 88 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | — / 4 | OpenAlex's profile for last-listed author Robert Trafficante holds only 1 work(s), too few to judge a track record — left out of this score |
| Institution's track record | 0 / 3 | Westmead Hospital: institution h-index 566 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 2 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 15551331) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 50 / 96 | Scored on 19 of 20 parts. We have no data for the rest, so they are left out: 50 of the 96 points we could judge it on is 52 out of 100. |
| Total | 52 / 100 | — |
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