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Neurology. 2008 Apr 15;70(16 Pt 2):1423-30. doi: 10.1212/01.wnl.0000310414.85144.ee.

Parkinson disease and risk of mortality: a prospective comorbidity-matched cohort study.

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1
Harvard Medical School, Brigham and Women's Hospital, Division of Aging, 1620 Tremont St., Boston, MA 02120-1613, USA.

Abstract

OBJECTIVE:

To evaluate the association between Parkinson disease (PD) and mortality after adjustment for comorbidities.

METHODS:

We conducted a matched cohort analysis among 22,071 participants in the Physicians' Health Study. Five hundred sixty incident PD cases were identified by self-report. We used a modified Charlson Comorbidity Index to calculate a comorbidity score. Each PD case was matched by age to a comparator who was alive and had an identical comorbidity score at the time of PD diagnosis of the case. Both cohorts were followed for all-cause mortality. We used proportional hazards models to calculate hazard ratios (HRs) for mortality.

RESULTS:

A total of 330 participants died over a median follow-up of 5.8 years, 200 (35.7%) in the PD group and 130 (23.2%) in the reference group. After adjustment for smoking and age at PD onset, the HR for mortality was 2.32 (95% CI 1.85-2.92). The mortality risk remained significant with increasing age at onset, even in those aged >or=80 years (HR = 2.10; 95% CI 1.44-3.00). The increased risk was apparent for short PD duration (<2 years) and remained stable with increasing duration. We found no different risk of mortality associated with PD according to smoking status.

CONCLUSIONS:

In this large prospective cohort of men and after matching on comorbidities, we found that Parkinson disease patients had an increased risk of all-cause mortality. Mortality was increased regardless of disease duration, did not diminish with increasing age at onset, and was not influenced by smoking status.

[Indexed for MEDLINE]

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