What predicts mortality in Parkinson disease?

Abstract

This population-based long-term study demonstrates that in addition to AAO, chronological age, motor severity, and dementia, psychotic symptoms independently predict increased mortality in PD. In contrast, no significant impact of antipsychotic or antiparkinsonian drugs on survival was observed in our PD cohort. Early prevention of motor progression and development of psychosis and dementia may be the most promising strategies to increase life expectancy in PD.

The Profile of Long-term Parkinson’s Disease Survivors with 20 Years of Disease Duration and Beyond

“…The most apparent explanation is the PD-20 population had earlier onset disease, on average in the fifth decade compared with the seventh decade for PD cases overall. Early-onset PD is known to predict a milder disease course with longer survival and less disability compared to lateronset PD [5,12,13]. In addition, early-onset PD is more likely to include patients with autosomal recessive genetic variants [14].…”

“…There has been a paucity of data on long-term PD survivors to date [5,6]. The Sydney Multicenter Study followed 136 community-dwelling PD patients over a 20-year period.…”

“…Early prevention of motor symptom progression, dementia, and psychosis has been suggested as an important direction for increasing life expectancy in PD [5], although there are no existing preventive medications or strategies. The prospective nature of the NPF-QII clinical study enhances its ability to provide this type of information.…”

“…Several risk factors negatively impact PD survival including demographic factors, such as older age at onset [1]; PD factors, such as psychosis, dementia, and motor severity [4,5]; and non-PD factors, such as pneumonia and cachexia [3]. Very few PD patients survive beyond 20 years, particularly those who develop PD in their seventh or eighth decades.…”

Mortality and Revision Surgery Are Increased in Patients With Parkinson’s Disease and Fractures of the Femoral Neck

“…The Unified Parkinson's Disease Rating Scale (UPDRS) is the most commonly used scale in the clinical study of Parkinson's disease [22]. Because the UPDRS is associated with increased mortality [10], classification of our Parkinson's disease group would have allowed us to stratify patients according to the severity of their disease. Second, we were unable to accurately quantify the number of patients with Parkinson's disease who had coexisting dementia.…”