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A 61-Year-Old Man With Parkinson's Disease, 1 Year Later

Warren E. Enker, MD
JAMA. 1997;277(3):212. doi:10.1001/jama.1997.03540270038021.
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To the Editor.  —A recent Clinical Crossroads article1 reviewed the course of a retired dentist 1 year after the presentation of his case at Neurology Grand Rounds. At this time, the patient paints a rather devastating picture of how his life has deteriorated in so many ways. To anyone who has ever witnessed the deterioration of a previously vital and vibrant patient who is disabled by Parkinson disease, however subjective the changes may seem, every one of this patient's physical and emotional changes is real.With the exception of some superficial comments about the patient's speech and about his inability to remain as active as he once was, Dr C, the primary care physician, has captured nothing about what the patient relates as his overall decline in well-being. When it comes to the patient's decline in cognitive function, the primary care physician indicates that despite the patient's complaints, an objective


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