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Arch Neurol. 2012 May;69(5):601-7.

Predictors of survival in patients with Parkinson disease.

Author information

1
Department of Neurology, Washington University School of Medicine, St Louis, MO 63110, USA. willisa@neuro.wustl.edu

Abstract

OBJECTIVE:

To determine the life expectancy of patients with Parkinson disease (PD) in the United States and identify demographic, geographic, and clinical factors that influence survival.

DESIGN:

Retrospective cohort study of 138 000 Medicare beneficiaries with incident PD who were identified in 2002 and followed up through 2008.

MAIN OUTCOME MEASURES:

Confounder-adjusted 6-year risk of death as influenced by 3 groups of factors: (1) race, sex, and age at diagnosis; (2) geography and environmental factors; and (3) clinical conditions. We examined hospitalization diagnoses in patients with terminal PD and compared PD mortality with that of other common diseases.

RESULTS:

Thirty-five percent of patients with PD lived more than 6 years. Sex and race significantly predicted survival; patients who were female (HR [hazard ratio], 0.74; 95% CI, 0.73-0.75), Hispanic (HR, 0.72; 95% CI, 0.65-0.80), or Asian (HR, 0.86; 95% CI, 0.82-0.91) had a lower adjusted risk of death than white men. Dementia, diagnosed in 69.6% of cases and most often in African American patients (78.2%) and women (71.5%), was associated with a greater likelihood of death (HR, 1.72; 95% CI, 1.69-1.75). Parkinson disease mortality was greater than that of many common life-threatening diseases. Patients with terminal PD were hospitalized frequently for cardiovascular disease (18.5%) and infection (20.9%) but rarely for PD (1.0%). Regional survival rates were similar but patients with PD living in urban high industrial metal emission areas had a slightly higher adjusted risk of death (HR, 1.19; 95% CI, 1.10-1.29).

CONCLUSIONS:

Demographic and clinical factors impact PD survival. Dementia is highly prevalent in patients with PD and is associated with a significant increase in mortality. More research is needed to understand whether environmental exposures influence PD course or survival.

PMID:
22213411
PMCID:
PMC3599783
DOI:
10.1001/archneurol.2011.2370
[Indexed for MEDLINE]
Free PMC Article

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