Determinants of delayed diagnosis in Parkinson's disease

J Neurol. 2013 Aug;260(8):1978-81. doi: 10.1007/s00415-013-6905-3. Epub 2013 Apr 10.


The early and accurate diagnosis of Parkinson's disease (PD) is the first step towards optimal patient management. The aim of this study was to investigate the major determinants of delayed diagnosis in PD. We recruited a population-representative cohort of 239 newly-diagnosed PD patients who underwent clinical and neuropsychological evaluation. Non-parametric methods were used to define the factors associated with diagnostic delay. The median time from motor symptom onset to primary care physician (PCP) presentation was considerably longer than the time from PCP presentation to PD diagnosis (11 vs. 1 months). Male sex and presenting motor phenotype were independently associated with delayed PCP presentation on Cox regression analysis. Patients presenting with gait disturbance experienced the longest delay, whilst those presenting with tremor had the shortest. In summary, male sex and presenting motor phenotype are key determinants of delayed diagnosis in PD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Antiparkinson Agents / therapeutic use
  • Cohort Studies
  • Delayed Diagnosis / statistics & numerical data*
  • Female
  • Gait Disorders, Neurologic / diagnosis
  • Gait Disorders, Neurologic / etiology
  • Humans
  • Male
  • Middle Aged
  • Parkinson Disease / diagnosis*
  • Parkinson Disease / epidemiology
  • Parkinson Disease / physiopathology
  • Phenotype
  • Population
  • Primary Health Care / statistics & numerical data
  • Regression Analysis
  • Sex Factors
  • Socioeconomic Factors
  • Tremor / diagnosis
  • Tremor / etiology


  • Antiparkinson Agents