Advance care planning and proxy decision making for patients with advanced Parkinson disease.

Objectives: To examine advance care planning practices and proxy decision making by family healthcare proxies for patients with advanced Parkinson disease (PD).

Methods: Sixty-four spouses and adult children, self-designated as a/the healthcare proxy for advanced patients with PD, participated in a cross-sectional survey study.

Results: Sixty patients with PD (95%) had completed a living will, but only 38% had shared the document with a physician.

Parkinson disease: research update and clinical management.

More than 1 million people in the United States have Parkinson disease (PD), more than are diagnosed as having multiple sclerosis, amyotrophic lateral sclerosis, muscular dystrophy, and myasthenia gravis combined. PD affects approximately 1 in 100 Americans older than 60 years. It burdens patients, their care partners, and the overall healthcare system.

Unrecognized GERD symptoms are associated with excessive daytime sleepiness in patients undergoing sleep studies.

Sleep disturbances are commonly reported by patients who suffer from gastroesophageal reflux disease (GERD) but it is uncertain if GERD plays a role in patients with sleep disorders of undetermined origin. The prevalence of GERD in patients with sleep disorders of unknown etiology is uncertain; the aim of this study was to determine this prevalence. Three hundred eighty-five consecutive patients reporting to an outpatient clinic for evaluation of sleep disorders were assessed for their sleepiness in relation to reflux symptom intensity.

Parasomnias.

Parasomnias are common in the benign forms such as sleepwalking and sleep talking. The more dramatic forms such as sleep terrors and confusional awakenings occur frequently in childhood, but attenuate in the teen years. REM behavior disorder, seen in the elderly, is an uncommon entity.