Cause of death among patients with Parkinson's disease: a rare mortality due to cerebral haemorrhage

Abstract

Causes of death, with special reference to cerebral haemorrhage, among 240 patients with pathologically verified Parkinson's disease were investigated using the Annuals of the Pathological Autopsy Cases in Japan from 1981 to 1985. The leading causes of death were pneumonia and bronchitis (44.1%), malignant neoplasms (11.6%), heart diseases (4.1%), cerebral infarction (3.7%) and septicaemia (3.3%). Cerebral haemorrhage was the 11th most frequent cause of death, accounting for only 0.8% of deaths among the patients, whereas it was the 5th most common cause of death among the Japanese general population in 1985. The low incidence of cerebral haemorrhage as a cause of death in patients with Parkinson's disease may reflect the hypotensive effect of levodopa and a hypotensive mechanism due to reduced noradrenaline levels in the parkinsonian brain.

Hypotensive Effect of Long-Term Levodopa in Patients with Parkinson’s Disease

“…Consequently, complications due to hyperten sion may be rare in Parkinson's disease. In our study of causes of death among pathologically verified patients with Parkinson's disease from 1981 to 1985 in Japan, cerebral hemorrhage was a rare cause of death, even though it was one of the leading causes among the gen eral population [27],…”

Unexpected and unexplained increase in death due to neurological disorders in 2012 in England and Wales: Is cytomegalovirus implicated?

“…poor nutritional status), have distressing levels of poor comfort, including symptoms of illness, which they are usually not able to communicate [18]. Hence the very high reported levels of pneumonia and febrile conditions [18,19]. This cascade is illustrated in Fig.…”

“…In all three cases the actual event precipitating death is usually an infection, neoplasm or cardiovascular event [18,19]. The most clinically relevant observations regarding these diseases is that toward the end of life persons with these degenerative conditions tend to become bed ridden (i.e.…”

The ACE Deletion Polymorphism Is Not Associated with Parkinson’s Disease

“…While some studies have found that the incidence of stroke was significantly lower in PD patients than controls [12, 13], others have found no significant difference [14]. Similarly, the relationship between hypertension and PD is not clear.…”

“…Similarly, the relationship between hypertension and PD is not clear. PD patients are less likely to suffer from clinical hypertension [15, 16]and many anti-parkinsonian drugs initiate hypotensive effects due to a reduction in noradrenalin levels in the parkinsonian brain [13]. Nonetheless, there is no direct evidence to suggest that hypertension is protective with respect to PD.…”