Survival and related factors in patients with Parkinson's disease: a multicenter prospective cohort study in China

Parkinson's disease (PD) is the second most common neurodegenerative disease and the fastest-growing disability-causing neurological disorder worldwide. Based on the CPDR cohort from 19 clinical centers, we summarized the mortality information and characteristics of patients with PD, and analyzed the related factors affecting their survival. After a 6-year follow-up period, 562 of the 3,148 patients died, with a mortality rate of 3.03 deaths per 100 person-years, and a median survival time from disease onset of 23.33 years. The most common cause of death was cardiovascular disease, followed by cerebrovascular disease and respiratory disease. Older age at onset, carriers of GBA1 gene variants, type 2 diabetes, higher LEDD, late H&Y stage (especially H&Y stage 4 and H&Y stage 5), higher UPDRS part Ⅲ scores, a history of falls, depression, and cognitive dysfunction were associated with increased mortality. In contrast, undergoing deep brain stimulation (DBS) surgery and higher educational attainment was associated with a lower risk of death. Our findings contributed to further expanding the survival data of PD and advocated for early identification of high-risk patients for timely intervention to improve prognosis.