More rapid change ( ie , worsening ) in the UPDRS Part II score ( hazard ratio , 1.15 [ 95 % CI , 1.08-1 .22 ] for 1 scale unit change per 6 months ) , the UPDRS Part III score ( hazard ratio , 1.09 [ 95 % CI , 1.06-1 .13 ] for 1 scale unit change per 6 months ) , and the Schwab and England Independence Scale score ( hazard ratio , 1.29 [ 95 % CI , 1.12-1 .48 ] for 5 percentage point change per 6 months ) was associated with earlier need for symptomatic therapy .