Predictors of Mortality in Nondemented Patients With Parkinson Disease: Motor Symptoms Versus Nonmotor Symptoms

Santos‐García, Diego; Suárez-Castro, E.; Ernandez, John; Expósito-Ruiz, I.; Tuñas-Gesto, Cintia; Aneiros-Díaz, M.; Deus-Fonticoba, Teres de; López-Fernandez, MFernanda; Núñez-Arias, D.

doi:10.1177/0891988717743589

Cited by 27 publications

(9 citation statements)

References 43 publications

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“…Nonmotor symptoms are typically the main determinant of PD patients' quality of life [15], and certain nonmotor symptoms have been identified as risk factors for mortality [16]. Consistent with the present results, psychotic symptoms [17][18][19] and cognitive impairment/dementia [17,18,20,21] have previously been shown to be associated with an increased risk of death in patients with PD.…”

Section: Discussionsupporting

confidence: 90%

“…Previous studies have also suggested that an early development of autonomic dysfunction or individual autonomic abnormalities (including constipation, orthostatic hypotension, urinary symptoms, upper gastrointestinal tract symptoms, sweating abnormalities, and erectile dysfunction in males) are independent determinants of more rapid disease progression and shorter survival in patients already diagnosed with PD [22]. Constipation was also associated with a higher risk of death in diagnosed PD patients in Kaplan-Meier analysis [16]. However, to our knowledge, there are no previous reports on the direct association between pain and survival in PD.…”

Section: Discussionmentioning

confidence: 88%

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Prediagnostic expressions in health records predict mortality in Parkinson's disease: A proof-of-concept study

Kuusimäki

Sainio

Kurki

et al. 2022

Parkinsonism & Related Disorders

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Introduction:The relationship of prodromal markers of PD with PD mortality is unclear. Electronic health records (EHRs) provide a large source of raw data that could be useful in the identification of novel relevant prognostic factors in PD. We aimed to provide a proof of concept for automated data mining and pattern recognition of EHRs of PD patients and to study associations between prodromal markers and PD mortality. Methods: Data from EHRs of PD patients (n = 2522) were collected from the Turku University Hospital database between 2006 and 2016. The data contained >27 million words/numbers and >750000 unique expressions. The 5000 most common words were identified in three-year time period before PD diagnosis. Cox regression was used to investigate the association of expressions with the 5-year survival of PD patients. Results: During the five-year period after PD diagnosis, 839 patients died (33.3%). If expressions associated with psychosis/hallucinations were identified within 3 years before the diagnosis, worse survival was observed (hazard ratio = 1.71, 95%CI = 1.46-1.99, p < 0.001). Similar effects were observed for words associated with cognition (1.23, 1.05-1.43, p = 0.009), constipation (1.34, 1.15-1.56, p = 0.0002) and pain (1.34, 1.12-1.60, p = 0.001). Conclusions: Automated mining of EHRs can predict relevant clinical outcomes in PD. The approach can identify factors that have previously been associated with survival and detect novel associations, as observed in the link between poor survival and prediagnostic pain. The significance of early pain in PD prognosis should be the focus of future studies with alternate methods.

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 88%

Prediagnostic expressions in health records predict mortality in Parkinson's disease: A proof-of-concept study

Kuusimäki

Sainio

Kurki

et al. 2022

Parkinsonism & Related Disorders

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“…The purpose of the current analyses was to assess predictors of increased mortality among ET cases. In this sense, the study is similar to numerous studies of Parkinson's disease from around the world that aimed to assess predictors of mortality, in which cases but no controls were enrolled (43–47).…”

Section: Discussionmentioning

confidence: 99%

What Predicts Mortality in Essential Tremor? A Prospective, Longitudinal Study of Elders

et al. 2018

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Objective: Essential tremor (ET) is among the most common neurologic diseases. Although in the past it was considered a benign condition, recent research has demonstrated increased risk of mortality. To date, however, no studies have examined predictors of mortality in ET.Methods: In a longitudinal, prospective study of 141 elders with ET, we used Cox proportional-hazards models to estimate hazard ratios (HRs) for death.Results: The mean baseline age was 81.1 ± 8.8 years. During the follow-up interval, 27 (19.1%) died. Average time from baseline to death was 12.3 ± 8.7 months (range = 0.3–31.2). In univariate Cox regression models, older age (HR = 1.16, p < 0.001), lower Montreal Cognitive Assessment score (HR = 0.88, p = 0.004), higher Clinical Dementia Rating (CDR) score (HR = 4.53, p < 0.001), higher score on the Geriatric Depression scale (GDS) (HR = 1.07, p = 0.048), less balance confidence (HR = 0.98, p = 0.006), more falls (HR = 1.11, p = 0.003), and more tandem mis-steps (HR = 1.53, p = 0.004) were associated with increased risk of mortality. In the final multivariate Cox model, older age (HR = 1.14, p = 0.005), higher CDR score (HR = 3.80, p = 0.002) and higher GDS (HR = 1.11, p = 0.01) were independently associated with increased risk of mortality.Conclusions: This study highlights several independent predictors of mortality in elderly ET; clinicians should consider screening for depressive symptoms, assessing cognition and tracking CDR scores, and assessing balance while evaluating patients with ET.

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“…carry out ADL were at a higher risk of death in the short term (Santos-García et al, 2018). It is possible that targeted treatment of the separate DASH components would be beneficial, as both pharmacological (Schapira, Chaudhuri, & Jenner, 2017;Titova & Chaudhuri, 2018) and nonpharmacological (Cusso, Donald, & Khoo, 2016) treatments exist to ameliorate these symptoms.…”

Section: Discussionmentioning

confidence: 99%

Association of cognitive activities of daily living (ADL) function and nonmotor burden in nondemented Parkinson’s disease patients.

Becker¹,

Bäumer²,

Maetzler³

et al. 2020

Neuropsychology

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Objective: In Parkinson's disease (PD), nonmotor symptoms (NMS) considerably influence disease progression and cognitive decline. Depression, anxiety, sleep disturbances, and hallucinations (DASH), may indicate a risk for dementia (PDD). Mild impairments in activities of daily living (ADL) caused by cognitive dysfunction are also present in the prodromal stage of PDD. The association of both factors has been sparsely investigated. Aim was to evaluate these specific NMS in a large nondemented PD cohort and their co-occurrence with cognitive dysfunction and ADL impairments. Method: Data of 226 PD

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Predictors of Mortality in Nondemented Patients With Parkinson Disease: Motor Symptoms Versus Nonmotor Symptoms

Abstract: Both motor complications (UPDRS-IV) and NMS (NMSS) were associated with mortality at 4 years, being motor complications an independent predictor of it.

Cited by 27 publications

References 43 publications

Prediagnostic expressions in health records predict mortality in Parkinson's disease: A proof-of-concept study

Prediagnostic expressions in health records predict mortality in Parkinson's disease: A proof-of-concept study

What Predicts Mortality in Essential Tremor? A Prospective, Longitudinal Study of Elders

Association of cognitive activities of daily living (ADL) function and nonmotor burden in nondemented Parkinson’s disease patients.

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