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Original Articles
Increased Mortality in Young-Onset Parkinson’s Disease
Eldbjørg Hustad, Tor Åge Myklebust, Sasha Gulati, Jan O. Aasly
J Mov Disord. 2021;14(3):214-220.   Published online July 29, 2021
DOI: https://doi.org/10.14802/jmd.21029
  • 14,942 View
  • 235 Download
  • 4 Citations
AbstractAbstract PDF
Objective
Few studies have followed Parkinson’s disease (PD) patients from the time of diagnosis to the date of death. This study compared mortality in the Trondheim PD cohort to the general population, investigated causes of death and analyzed the associations between mortality and age at disease onset (AAO) and cognitive decline defined as Montreal Cognitive Assessment (MoCA) score below 26.
Methods
The cohort was followed longitudinally from 1997. By the end of January 2020, 587 patients had died. Comparisons to the Norwegian population were performed by calculating standardized mortality ratios (SMRs). Survival curves were estimated using the standard Kaplan-Meier estimator, and multivariable Cox proportional hazard models were estimated to investigate associations.
Results
SMR was 2.28 [95% confidence interval (CI): 2.13–2.44] for the whole cohort. For participants with AAO 20–39 years, the SMR was 5.55 (95% CI: 3.38–8.61). Median survival was 15 years (95% CI: 14.2–15.5) for the whole cohort. Early-onset PD (EOPD) patients (AAO < 50 years) had the longest median survival time. For all groups, there was a significant shortening in median survival time and an almost 3-fold higher age- and sex-adjusted hazard ratio for death when the MoCA score decreased below 26.
Conclusion
PD patients with an AAO before 40 years had a more than fivefold higher mortality rate compared to a similar general population. EOPD patients had the longest median survival; however, their life expectancy was reduced to a greater degree than that of late-onset PD patients. Cognitive impairment was strongly associated with mortality in PD.

Citations

Citations to this article as recorded by  
  • Real-World Prescription Patterns For Patients With Young-Onset Parkinson’s Disease in China: A Trend Analysis From 2014 to 2019
    Xiao-qin Liu, Xiao-yu Wang, Hui-ming Shen, Wen-yuan Pang, Ming-kang Zhong, Chun-lai Ma
    Frontiers in Pharmacology.2022;[Epub]     CrossRef
  • Montreal cognitive assessment (MoCA) is highly correlated with 1-year mortality in hip fracture patients
    R. M. Y. Wong, R. W. K. Ng, W. W. Chau, W. H. Liu, S. K. H. Chow, C. Y. Tso, N. Tang, W.-H. Cheung
    Osteoporosis International.2022; 33(10): 2185.     CrossRef
  • Obituary for Jan O. Aasly (1950–2022)
    Matthew J. Farrer
    Movement Disorders.2022; 37(9): 1783.     CrossRef
  • Age Cutoff for Early‐Onset Parkinson's Disease: Recommendations from the International Parkinson and Movement Disorder Society Task Force on Early Onset Parkinson's Disease
    Raja Mehanna, Katarzyna Smilowska, Jori Fleisher, Bart Post, Taku Hatano, Maria Elisa Pimentel Piemonte, Kishore Raj Kumar, Victor McConvey, Baorong Zhang, Eng‐King Tan, Rodolfo Savica, Rodolfo Savica, Eng‐King Tan, Raja Mehanna, Katarzyna Smilowska, Conn
    Movement Disorders Clinical Practice.2022; 9(7): 869.     CrossRef
The Queensland Parkinson’s Project: An Overview of 20 Years of Mortality from Parkinson’s Disease
Peter Cornelis Poortvliet, Alexander Gluch, Peter A. Silburn, George D. Mellick
J Mov Disord. 2021;14(1):34-41.   Published online December 7, 2020
DOI: https://doi.org/10.14802/jmd.20034
  • 6,686 View
  • 177 Download
  • 6 Citations
AbstractAbstract PDF
Objective
The consensus is that life expectancy for individuals with Parkinson’s disease (PD) is reduced, but estimations vary. We aimed to provide an overview of 20 years of mortality and risk factor data from the Queensland Parkinson’s Project.
Methods
The analysis included 1,334 PD and 1,127 control participants. Preliminary analysis of baseline characteristics (sex, age at onset, family history, smoking status, pesticide exposure, depression and neurosurgery) was conducted, and Kaplan–Meier curves were generated for each potential risk factor. Standardized mortality ratios (SMRs) were calculated comparing this cohort to the general Australian population. Cox proportional hazards regression modeling was used to analyze potential predictors of mortality.
Results
In total, 625 (46.8%) PD and 237 (21.0%) control participants were deceased. Mean disease duration until death was 15.3 ± 7.84 years. Average ages at death were 78.0 ± 7.4 years and 80.4 ± 8.4 years for the deceased PD and control participants, respectively. Mortality was significantly increased for PD in general {SMR = 2.75 [95% confidence interval (CI): 2.53–2.96]; p = 0.001}. SMRs were slightly higher for women and those with an age of onset before 60 years. Multivariate analysis showed that deep brain stimulation (DBS) treatment was associated with lower mortality [hazard ratio (HR) = 0.76; 95% CI: 0.59–0.98], while occasional pesticide exposure increased mortality risk (HR = 1.48; 95% CI: 1.17–1.88). Family history of PD, smoking and depression were not independent predictors of mortality.
Conclusion
Mortality in PD is increased. Sex, age at onset and occasional pesticide exposure were independent determinants of increased mortality, while DBS treatment was associated with reduced mortality.

Citations

Citations to this article as recorded by  
  • Mortality of Parkinson’s disease in Italy from 1980 to 2015
    Monica Ulivelli, Daiana Bezzini, Lucia Kundisova, Ilaria Grazi, Mario Alberto Battaglia, Nicola Nante, Simone Rossi
    Neurological Sciences.2022; 43(6): 3603.     CrossRef
  • A nationwide study of the incidence, prevalence and mortality of Parkinson’s disease in the Norwegian population
    Brage Brakedal, Lilah Toker, Kristoffer Haugarvoll, Charalampos Tzoulis
    npj Parkinson's Disease.2022;[Epub]     CrossRef
  • Australian Parkinson’s Genetics Study (APGS): pilot (n=1532)
    Svetlana Bivol, George D Mellick, Jacob Gratten, Richard Parker, Aoibhe Mulcahy, Philip E Mosley, Peter C Poortvliet, Adrian I Campos, Brittany L Mitchell, Luis M Garcia-Marin, Simone Cross, Mary Ferguson, Penelope A Lind, Danuta Z Loesch, Peter M Vissche
    BMJ Open.2022; 12(2): e052032.     CrossRef
  • Therapeutic targeting of mitophagy in Parkinson's disease
    Shashank Masaldan, Sylvie Callegari, Grant Dewson
    Biochemical Society Transactions.2022; 50(2): 783.     CrossRef
  • Worldwide trends in mortality related to Parkinson's disease in the period of 1994–2019: Analysis of vital registration data from the WHO Mortality Database
    Ioannis C. Lampropoulos, Foteini Malli, Olga Sinani, Konstantinos I. Gourgoulianis, Georgia Xiromerisiou
    Frontiers in Neurology.2022;[Epub]     CrossRef
  • Effects of physician visit frequency for Parkinson’s disease treatment on mortality, hospitalization, and costs: a retrospective cohort study
    Takako Fujita, Akira Babazono, Sung-a Kim, Aziz Jamal, Yunfei Li
    BMC Geriatrics.2021;[Epub]     CrossRef

JMD : Journal of Movement Disorders