Longitudinal Investigation of Autonomic Symptoms in Biologically Confirmed (SAA+) Parkinson's Disease

In early, biologically confirmed Parkinson’s disease, autonomic symptom burden rises from 71% at baseline to 85% after 5-year follow-up, far exceeding healthy controls.

• Why it matters: Autonomic symptoms are frequent in Parkinson disease, but their long-term progression and links to motor and cognitive decline remain unclear.
• What they did: Using Parkinson Progression Markers Initiative data (874 PD, 252 healthy controls), autonomic domains were tracked annually for 5 years with SCOPA-AUT and analyzed with generalized estimating equations adjusting for age, sex, medication, and comorbidities.
• The result: Higher baseline autonomic burden predicted more rapid cognitive decline in PD (p=0.002) but not motor decline, supporting early assessment and management of severe autonomic symptoms.

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