Study of the structure of the Parkinson’s disease incidence in Karaganda region. Drawing up a routing plan

M. A. Grigolashvili; M. B. Beisembayeva; A. A. Rakhimzhanova; O. A. Mungalova; Zh. S. Zhakhanova

Study of the structure of the Parkinson’s disease incidence in Karaganda region. Drawing up a routing plan

M. A. Grigolashvili, M. B. Beisembayeva, A. A. Rakhimzhanova, O. A. Mungalova, Zh. S. Zhakhanova

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Abstract

Parkinson’s disease is a progressive, clinically variable neurodegenerative disease, and its prevalence is projected to double over the next 20 years. Practice shows that the diagnosis of Parkinson’s disease is based on clinical manifestations, and the key symptoms are bradykinesia, rigidity and tremor. In addition to motor defects, Parkinson’s disease is also associated with non-motor symptoms, including autonomic dysfunction, depression, anxiety and hallucinations, which can make it difficult to initially diagnose Parkinson’s disease. Therapy for motor defect includes levodopa/carbidopa-based drugs, monoamine oxidase-B inhibitors and dopamine agonists. However, prolonged use and higher doses of levodopa have not demonstrated the ability to slow the progression of the disease, leading over time to dyskinesia and fluctuations in motor symptoms. In this connection, neurosurgical methods of treatment are used in world practice for those who do not achieve adequate control during levodopa therapy. Despite the fact that in Parkinson’s disease, the help of a neurologist is fundamental, a general practitioner is often the first link for patients with early symptoms who need treatment and specialist advice.
The purpose of the study: analysis of clinical cases of Parkinson’s disease in the Karaganda region and drawing up a routing plan.
Materials and methods: a retrospective analysis of outpatient and inpatient records with a verified diagnosis of Parkinson’s disease according to age, gender, clinical stages according to the modified Hyun–Yar scale, the choice of therapy and the identified complications was carried out. An algorithm of actions at the outpatient level is provided, contributing to an effective interdisciplinary approach between a general practitioner, a neurologist and an office of extrapyramidal disorders.
Results. The average age of patients with the incidence of Parkinson’s disease in the Karaganda region was 66.5±9.02. The frequency of occurrence in women (n=138, 62.4%) prevails 1.6 times more than in men (n=83 37.5%). In the structure of morbidity, the most common age group among women was the age from 60 to 69 years (n=66), for men equally from 60 to 79 years (n=54). Alternative methods of neurosurgical treatment have been identified that can be considered in individual patients with PD to improve motor symptoms. The average duration of the disease was 7.3±2.3 (range 49-71 years) when selecting patients for surgical treatment according to international indications for deep brain stimulation.
Conclusion. In this scientific study, a retrospective analysis of gender, age data, clinical stages according to the modified Hen-Yar scale, the choice of therapy and identified complications with an established diagnosis of Parkinson’s disease in the Karaganda region and a comparative characteristic with the available world statistics was carried out, discrepancies in indicators were identified, and the most likely cause of their discrepancy was identified, the main methods of treatment used in international practice were described, followed by comparison in practice in Kazakhstan and the Karaganda region.

Keywords

Parkinson’s disease, Kazakhstan, morbidity, levodopa, DBS