Frequency and Associated Factors of Autonomic Dysfunction in Patients with Parkinson’s Disease in Khartoum State

Abstract
Background: Autonomic dysfunction in idiopathic Parkinson disease is a frequent and disabling complication, with an estimated prevalence of 47% and has a significant impact on the patient’s quality of life. Objectives: The main objective of this study was to determine the frequency of autonomic dysfunction among Sudanese Parkinson patients and identify possible risk factors attribute to develop autonomic dysfunction and to assess the extent to which the progression of dysautonomia affects activities of daily living, health-related quality of life. Methods: In this descriptive perspective, cross-sectional hospital-based study, 51 patients were studied using standardized questionnaire including history and clinical examination. Results: A total of 51 patients have been examined: male to female ratio 1.5:1; mean age 55 ± 5 years; Parkinson disease duration, 7 ± 2 years. 47% of the patients had one or more symptoms of autonomic dysfunction with mean age 59 ± 10. Constipation and bloating were the most common symptoms where sweating abnormality was the least symptoms to observe. The symptom of autonomic dysfunction has been worse with disease progression in 50% of the patients and 47% of the patients reported that both motors and autonomic dysfunction symptoms were causing disability than autonomic dysfunction symptoms alone. Conclusions: The study demonstrates that autonomic dysfunction is not only common in Parkinson Disease, but it increases in severity with increasing disease stages. Older age with long disease duration was also considered along with advanced disease stages strong factors determining the presence of autonomic dysfunction. The study recommends that symptoms of autonomic dysfunction survey be a routine aspect of the evaluation of Parkinson disease patients, especially with advanced age.