Effectiveness of pathogenetic therapy of patients with Parkinson’s disease in the Kursk Region

INTRODUCTION: Analysis of the effectiveness of treatment for the disease is necessary to improve the medical care provided to the given category of patients. AIM: To determine the effectiveness of pathogenetic therapy of patients with Parkinson’s disease (PD) in the population of the Kursk region depending on age and stage according to the Hoehn–Yahr Rating Scale, and to assess the severity of the disease depending on gender and place of residence. MATERIALS AND METHODS: A total of 100 outpatients with a mixed form of PD aged 45–74 years (of them are 60 women and are 40 men) were examined. The mean age of the patients was 62.7 ± 6.2 years. Most patients lived in the rural region — 61.0% (32 women and 29 men), while 39.0% (28 women and 11 men) lived in the urban area. The severity of the disease was assessed according to the Hoehn–Yahr scale. Cognitive function was studied using the MMSE scale (Mini-Mental State Examination), the Frontal Assessment Battery (FAB), and the Clock Drawing test. RESULTS: The age of PD onset varied from 42 to 70 years (mean age 58.5 ± 6.7 years); in rural residents — 58.8 ± 6.9 years (in men — 58.6 ± 5.6 years, in women — 58.9 ± 5.8 years); in urban residents — 58.2 ± 6.5 years (in men — 57.1 ± 5.4 years, in women — 58.6 ± 6.9 years); p 0.05. Monotherapy with L-DOPA drugs was effective in 50.0% of cases, and with dopamine receptor agonists (DRA) in 53.0% of cases, combination therapy with DRA and L-DOPA preparations appeared to be more effective and made 72.5% of cases. CONCLUSION: In the studied cohort of patients with Parkinson’s disease, patients living in rural areas outnumbered the urban patients 1.5 times, however, the mean age of onset was comparable. Therapy for patients with Parkinson’s disease was staged consisting in prescribing monotherapy at the early stages of the disease with subsequent replacement with a combination of dopamine receptor agonists and levodopa. The greatest treatment efficiency in patients with a mixed form of Parkinson's disease is observed with combination therapy.