Case-Fatality Rate in Parkinson's Disease: A Nationwide Registry Study

Area of Science:

• Neurology
• Epidemiology
• Public Health

Background:

• Parkinson's disease (PD) is a neurodegenerative disorder with potential implications for patient survival.
• Previous estimates of mortality risk in PD patients lack robustness, necessitating further investigation.

Purpose of the Study:

• To conduct a national comparison of mortality rates between individuals diagnosed with Parkinson's disease and matched control groups.
• To quantify the excess mortality risk associated with PD.

Main Methods:

• A cohort of 23,688 Finnish PD patients diagnosed between 2004-2018 was compared with 94,752 age- and sex-matched controls.
• National registry data were utilized for case-fatality rate comparison over a median follow-up of 5.8 years (up to 17 years).

Main Results:

• PD patients exhibited a significantly higher case-fatality rate (HR 2.29) compared to controls, with excess mortality evident from one year post-diagnosis.
• The highest relative hazard of death was observed in early-onset PD patients (age <50 years), with the risk decreasing with increasing age at diagnosis.
• While long-term mortality risk did not differ by sex, the seven-year excess risk of death decreased over the study period, notably in men.

Conclusions:

• An elevated risk of death is associated with Parkinson's disease from an early stage.
• Young-onset PD patients face the greatest mortality hazard, though the excess risk for early PD cases has shown a decline over time, particularly in males.
• The underlying reasons for the observed decline in excess mortality risk in early Parkinson's disease remain undetermined.