Background/Aims: In 1996, Nebraska became the first state in the United States to establish a Parkinson’s disease (PD) Registry. The objectives of this study were to determine the most common comorbid conditions among PD patients receiving inpatient and outpatient services in Nebraska between 2004 and 2012, and to examine whether PD patients had increased risks of these conditions. Methods: Statewide linkage was performed between Nebraska PD Registry data and hospital discharge database. The cohort comprised of 3,852 PD inpatients and 19,260 non-PD inpatients, and 5,217 PD outpatients and 26,085 non-PD outpatients. Referent subjects were matched to PD patients by age at initial hospital admissions or visits, gender, and county of residence using systematic random-sampling method. Results: Compared to non-PD inpatients, PD inpatients were at higher risks for dementia (relative risk [RR] 2.29; 95% CI 2.14–2.45), mood disorders (RR 1.57; 95% CI 1.44–1.70), gastrointestinal disorders (RR 1.15; 95% CI 1.06–1.25), and urinary tract infections (RR 1.33; 95% CI 1.22–1.45), while PD outpatients had higher risks for spondylosis (RR 1.23; 95% CI 1.09–1.38), genitourinary disorders (RR 1.48; 95% CI 1.29–1.69), gastrointestinal disorders (RR 1.59; 95% CI 1.38–1.84), and dementia (RR 2.83; 95% CI 2.38–3.37) than non-PD outpatients. Conclusions: The findings highlight PD as a multisystem neurodegenerative disorder, and this information is crucial for creating strategies to better prevent and manage PD complications.

1.
Bertoni JM, Sprenkle PM, Strickland D, Noedel N: Evaluation of Parkinson’s disease in entrants on the nebraska state Parkinson’s disease registry. Mov Disord 2006; 21: 1623–1626.
2.
Levy G, Schupf N, Tang M, et al: Combined effect of age and severity on the risk of dementia in Parkinson’s disease. Ann Neurol 2002; 51: 722–729.
3.
Guttman M, Slaughter PM, Theriault ME, DeBoer DP, Naylor CD: Parkinsonism in ontario: Comorbidity associated with hospitalization in a large cohort. Mov Disord 2004; 19: 49–53.
4.
Leibson CL, Maraganore DM, Bower JH, Ransom JE, O’Brien PC, Rocca WA: Comorbid conditions associated with Parkinson’s disease: a population-based study. Mov Disord 2006; 21: 446–455.
5.
Nebraska Department of Health & Human Services: Nebraska Parkinson’s Disease Registry. http://dhhs.ne.gov/Reports/Parkinson%27s%20Disease%20Registry%20Brochure%202014.pdf. Published October, 2014 (accessed June 5, 2017).
6.
Utah Department of Health: Utah Parkinson Disease Registry. http://updr.org/. Published 2015 (accessed June 5, 2017).
7.
Rai NK, Goyal V, Kumar N, Shukla G, Srivastava AK, Singh S, Behari M: Neuropsychiatric co-morbidities in non-demented Parkinson’s disease. Ann Indian Acad Neurol 2015; 18: 33–38.
8.
Grover S, Somaiya M, Kumar S, Avasthi A: Psychiatric aspects of Parkinson’s disease. J Neurosci Rural Pract 2015; 65–76.
9.
Nuti A, Ceravolo R, Piccinni A, et al: Psychiatric comorbidity in a population of Parkinson’s disease patients. Eur J Neurol 2004; 11: 315–320.
10.
Lubomski M, Rushworth RL, Tisch S: Hospitalisation and comorbidities in Parkinson’s disease: a large australian retrospective study. J Neurol Neurosurg Psychiatry 2015; 86: 324–330.
11.
Nebraska Department of Health and Human Services: Public Health Data Inventory: Parkinson’s Disease Registry. http://dhhs.ne.gov/publichealth/DataCenter/Pages/Parkinsons.aspx. Published 2011. Updated June 3, 2013 (accessed June 6, 2017).
12.
Healthcare Cost and Utilization Project (HCUP): Clinical Classifications Software (CCS) for ICD-9-CM. https://www.hcup-us.ahrq.gov/toolssoftware/ccs/ccs.jsp. Updated March 6, 2017 (accessed May 19, 2017).
13.
Marder K, Tang MX, Cote L, Stern Y, Mayeux R: The frequency and associated risk factors for dementia in patients with Parkinson’s disease. Arch Neurol 1995; 52: 695–701.
14.
Kudlicka A, Clare L, Hindle JV: Executive functions in Parkinson’s disease: Systematic review and meta-analysis. Mov Disord 2011; 26: 2305–2315.
15.
Gibb WR, Lees AJ: The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 1988; 51: 745–752.
16.
Pavlakis AJ, Siroky MB, Goldstein I, Krane RJ: Neurourologic findings in Parkinson’s disease. J Urol 1983; 129: 80–83.
17.
Gustafsson H, Nordstrom A, Nordstrom P: Depression and subsequent risk of Parkinson disease: a nationwide cohort study. Neurology 2015; 84: 2422–2429.
18.
Riedel O, Klotsche J, Spottke A, et al: Frequency of dementia, depression, and other neuropsychiatric symptoms in 1,449 outpatients with Parkinson’s disease. J Neurol 2010; 257: 1073–1082.
19.
Oguh O, Videnovic A: Inpatient management of Parkinson disease: current challenges and future directions. Neurohospitalist 2012; 2: 28–35.
20.
Broetz D, Eichner M, Gasser T, Weller M, Steinbach JP: Radicular and nonradicular back pain in Parkinson’s disease: a controlled study. Mov Disord 2007; 22: 853–856.
21.
Etchepare F, Rozenberg S, Mirault T, et al: Back problems in Parkinson’s disease: an underestimated problem. Joint Bone Spine 2006; 73: 298–302.
22.
Tandeter H, Levy A, Gutman G, Shvartzman P: Subclinical thyroid disease in patients with Parkinson’s disease. Arch Gerontol Geriatr 2001; 33: 295–300.
23.
Munhoz RP, Teive HA, Troiano AR, et al: Parkinson’s disease and thyroid dysfunction. Parkinsonism Relat Disord 2004; 10: 381–383.
24.
Berger JR, Kelley RE: Thyroid function in Parkinson disease. Neurology 1981; 31: 93–95.
25.
Cestaro B, Cereda E: Endothelial progenitor cells: cardiovascular protection in Parkinson’s disease? Int J Cardiol 2015; 197: 200–202.
26.
Aviles-Olmos I, Limousin P, Lees A, Foltynie T: Parkinson’s disease, insulin resistance and novel agents of neuroprotection. Brain 2013; 136: 374–384.
27.
De Pablo-Fernández E, Breen DP, Bouloux PM, Barker RA, Foltynie T, Warner TT: Neuroendocrine abnormalities in Parkinson’s disease. J Neurol Neurosurg Psychiatry 2017; 88: 176–185.
28.
Becker C, Brobert GP, Johansson S, Jick SS, Meier CR: Diabetes in patients with idiopathic Parkinson’s disease. Diabetes Care 2008; 31: 1808–1812.
29.
Cereda E, Barichella M, Pedrolli C, Klersy C, Cassani E, Caccialanza R, Pezzoli G: Diabetes and risk of Parkinson’s disease. Diabetes Care 2011; 34: 2614–2623.
30.
Lu L, Fu DL, Li HQ, Liu AJ, Li JH, Zheng GQ: Diabetes and risk of Parkinson’s disease: an updated meta-analysis of case-control studies. PLoS One 2014; 9:e85781.
31.
De Pablo-Fernandez E, Sierra-Hidalgo F, Benito-Leon J, Bermejo-Pareja F: Association between Parkinson’s disease and diabetes: data from NEDICES study. Acta Neurol Scand 2017; 136: 732–736.
32.
Swarztrauber K, Graf E, Cheng E: The quality of care delivered to Parkinson’s disease patients in the U.S. Pacific Northwest Veterans Health System. BMC Neurology 2006; 6: 26.
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