Increased Mortality in Young-Onset Parkinson's Disease

Area of Science:

• Neurology
• Epidemiology
• Gerontology

Background:

• Parkinson's disease (PD) progression and mortality are not fully understood, particularly in longitudinal studies from diagnosis to death.
• Few studies have compared PD patient mortality to the general population or analyzed factors influencing survival.
• Understanding mortality patterns is crucial for improving patient care and life expectancy in PD.

Purpose of the Study:

• To compare mortality rates in a Parkinson's disease (PD) cohort with the general population.
• To investigate causes of death and analyze associations between mortality and age at disease onset (AAO) and cognitive decline (Montreal Cognitive Assessment [MoCA] score < 26).

Main Methods:

• Longitudinal follow-up of the Trondheim PD cohort from 1997 to January 2020.
• Calculation of standardized mortality ratios (SMRs) against the Norwegian population.
• Survival analysis using Kaplan-Meier and multivariable Cox proportional hazard models.

Main Results:

• The PD cohort exhibited a 2.28-fold higher mortality rate (SMR) than the general population.
• Individuals with early-onset PD (AAO 20-39 years) had a significantly higher SMR of 5.55.
• A MoCA score below 26 was associated with reduced median survival and a nearly 3-fold increased hazard ratio for death.

Conclusions:

• Parkinson's disease patients, particularly those with onset before age 40, face substantially increased mortality.
• Early-onset PD patients experience the longest median survival but a greater reduction in life expectancy.
• Cognitive impairment is a significant predictor of mortality in Parkinson's disease.