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Predictors of survival in patients with Parkinson disease.
Arch Neurol. 2012 May; 69(5):601-7.AN

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.

Authors+Show Affiliations

Department of Neurology, Washington University School of Medicine, St Louis, MO 63110, USA. willisa@neuro.wustl.eduNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

22213411

Citation

Willis, Allison W., et al. "Predictors of Survival in Patients With Parkinson Disease." Archives of Neurology, vol. 69, no. 5, 2012, pp. 601-7.
Willis AW, Schootman M, Kung N, et al. Predictors of survival in patients with Parkinson disease. Arch Neurol. 2012;69(5):601-7.
Willis, A. W., Schootman, M., Kung, N., Evanoff, B. A., Perlmutter, J. S., & Racette, B. A. (2012). Predictors of survival in patients with Parkinson disease. Archives of Neurology, 69(5), 601-7.
Willis AW, et al. Predictors of Survival in Patients With Parkinson Disease. Arch Neurol. 2012;69(5):601-7. PubMed PMID: 22213411.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Predictors of survival in patients with Parkinson disease. AU - Willis,Allison W, AU - Schootman,Mario, AU - Kung,Nathan, AU - Evanoff,Bradley A, AU - Perlmutter,Joel S, AU - Racette,Brad A, PY - 2012/1/4/entrez PY - 2012/1/4/pubmed PY - 2012/12/10/medline SP - 601 EP - 7 JF - Archives of neurology JO - Arch Neurol VL - 69 IS - 5 N2 - 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. SN - 1538-3687 UR - https://www.unboundmedicine.com/medline/citation/22213411/Predictors_of_survival_in_patients_with_Parkinson_disease_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/10.1001/archneurol.2011.2370 DB - PRIME DP - Unbound Medicine ER -