Mortality from Parkinson's disease: A population‐based prospective study (NEDICES)

Abstract

Most studies of mortality in Parkinson's disease have been clinical studies, yielding results that are not representative of the general population. We assessed the risk of mortality from Parkinson's disease in the Neurological Disorders in Central Spain (NEDICES) study, a prospective population-based study in which Parkinson's disease patients who were not ascertained through medical practitioners were also included. The cohort consisted of 5262 elderly subjects (mean baseline age, 73.0 years), including 81 with Parkinson's disease at baseline (1994-1995). Thirteen-year mortality was assessed. Two thousand seven hundred and one of 5262 subjects (51.3%) died over a median follow-up of 12.0 years (range, 0.04-14.8 years), including 66 of 81 subjects (81.5%) with Parkinson's disease at baseline and 2635 of 5181 subjects (50.8%) without Parkinson's disease at baseline. In an unadjusted Cox model, the hazard ratio of mortality was increased in subjects with Parkinson's disease (hazard ratio, 2.29; 95% confidence interval, 1.80-2.93; P < .001) versus subjects without Parkinson's disease (reference group). In a Cox model that adjusted for a variety of demographic factors and comorbidities, the risk of mortality remained elevated in subjects with Parkinson's disease (hazard ratio, 1.75; 95% CI, 1.32-2.31, P < .001). In additional Cox models, Parkinson's disease patients with dementia had particularly high risks of mortality (adjusted hazard ratio, 2.62; 95% CI, 1.40-4.90; P < .001). In this prospective population-based study, Parkinson's disease was an independent predictor of mortality in the elderly. Parkinson's disease patients with dementia had particularly high risks of mortality.

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

“…Parkinson's disease (PD) patients have shortened survival when compared with age-matched controls [1][2][3][4]. 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].…”

“…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.…”

Long sleep duration in elders without dementia increases risk of dementia mortality (NEDICES)

“…To address this question, we utilized data from the Neurological Disorders in Central Spain (NEDICES) Study, in which participants were followed for a median of 12.5 years, after which the death certificates of those who died were examined. [10][11][12][13][14][15][16][17][18][19][20] METHODS Study population. Data were derived from the NEDICES Study, a longitudinal, population-based survey of the epidemiology of major age-associated conditions of the elderly, including Parkinson disease, essential tremor, stroke, and dementia.…”

“…Data were derived from the NEDICES Study, a longitudinal, population-based survey of the epidemiology of major age-associated conditions of the elderly, including Parkinson disease, essential tremor, stroke, and dementia. [10][11][12][13][14][15][16][17][18][19][20] A detailed account of the NEDICES study population and sampling methods has been published. [21][22][23] The survey area consisted of 3 communities: (1) Las Margaritas (approximately 14,800 inhabitants), a working-class neighborhood in Getafe (Greater Madrid); (2) Lista (approximately 150,000 inhabitants), a professional-class neighborhood in the Salamanca district (Central Madrid); and (3) Arévalo (approximately 9,000 inhabitants), an agricultural zone of Arévalo County (located 125 km northwest of Madrid).…”

18F-FDG PET Is an Early Predictor of Overall Survival in Suspected Atypical Parkinsonism

“…According to clinical and clinicopathologic studies, MSA, PSP, and CBD share a comparably short survival time of about 7-8 y from symptom onset or less than 3-4 y from clinical diagnosis (1)(2)(3)(4)(5)(6)(7)(8). Survival in PD is distinctly better: although some population-based studies did not find higher mortality (9), others convincingly demonstrated an increased age-adjusted mortality in PD (10,11). As in APS (1,2,5,8), higher age at onset is also associated with a higher PD mortality (9,10), but median survival time was still 10.3 y in a recent population-based cohort with a high average age of 70 y at diagnosis (9).…”