Autonomic dysfunction in Indonesian patients with Parkinson’s disease

Abstract

Background & Objective: Autonomic dysfunction is a prevalent non-motor symptom in Parkinson’s disease (PD) and significantly affects patients’ quality of life. Despite its clinical importance, data on autonomic dysfunction in Indonesian PD populations were scarce. This study aims to characterize autonomic dysfunction and examine its associations with demographic and clinical subgroups in Indonesian PD patients using the SCOPA-AUT INA instrument.

Methods: We conducted a cross-sectional study involving 45 PD patients from the outpatient neurology clinic at Dr. Cipto Mangunkusumo Hospital between April 2023 and April 2024. Autonomic dysfunction was assessed using the SCOPA- AUT INA. Patients were grouped by age, sex, disease duration, disease severity, comorbidities, and anti-parkinsonian medications. Statistical analyses included chi-square, Kruskal–Wallis, Mann–Whitney U, and Spearman correlation tests.

Results: Autonomic dysfunction (SCOPA-AUT INA score ≥10) was present in 77.8% of subjects, with gastrointestinal (93.3%) and urinary (91.1%) symptoms being the most prevalent. Older patients (≥60 years) showed significantly higher SCOPA-AUT INA scores and urinary symptom severity. Longer disease duration was significantly associated with cardiovascular symptoms. Discrepancies were noted between categorical and continuous analyses of SCOPA-AUT INA, highlighting the challenge of defining cutoffs.

Conclusion: Autonomic dysfunction is highly prevalent in Indonesian PD patients, particularly among older individuals. The findings support the relevance of age and disease duration in shaping autonomic symptom profiles. SCOPA-AUT cutoff scores warrant further validation in larger, multicenter cohorts to improve clinical applicability.