Journal of Movement Disorders

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

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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

Levodopa–entacapone–carbidopa intestinal gel: Data from the Swedish national registry for Parkinson's disease
Mezin Öthman, Filip Bergquist, Per Odin, Monica Scharfenort, Anders Johansson, Ioanna Markaki, Per Svenningsson, Nil Dizdar, Dag Nyholm
European Journal of Neurology.2025;[Epub] CrossRef
The Evolving Global Burden of Young‐Onset Parkinson's Disease (1990–2021): Regional, Gender, and Age Disparities in the Context of Rising Incidence and Declining Mortality
Yanjie Jiang, Hanyu Wang, Xingyi He, Rui Fu, Zhihui Jin, Qinwei Fu, Xinlang Yu, Wenshan Li, Xiaoyu Zhu, Shipeng Zhang, Yan Lu
Brain and Behavior.2025;[Epub] CrossRef
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Parkinsonism & Related Disorders.2024; 129: 107052. CrossRef
Different neurotoxicity and seeding activity between α-synuclein oligomers formed in plasma of patients with Parkinson’s disease and multiple system atrophy
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Isabell Katharina Rumrich, Valtteri Kaasinen, Otto Hänninen, Sirpa Hartikainen, Anna-Maija Tolppanen
Environment International.2023; 173: 107852. CrossRef
Differences in Survival across Monogenic Forms of Parkinson's Disease
Aymeric Lanore, Fanny Casse, Christelle Tesson, Thomas Courtin, Poornima Jayadev Menon, Sara Sambin, Graziella Mangone, Louise‐Laure Mariani, Suzanne Lesage, Alexis Brice, Alexis Elbaz, Jean‐Christophe Corvol
Annals of Neurology.2023; 94(1): 123. CrossRef
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Xiao-qin Liu, Xiao-yu Wang, Hui-ming Shen, Wen-yuan Pang, Ming-kang Zhong, Chun-lai Ma
Frontiers in Pharmacology.2022;[Epub] CrossRef
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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
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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

14,498 View
251 Download
20 Web of Science
19 Crossref

Abstract 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

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