Parkinson's Disease and Respiratory Failure: Epidemiologic Insights of Two Decades From the CDC-WONDER Database

Parkinson's disease (PD) is the second most common neurodegenerative disorder, with increasing prevalence and mortality among older adults. Beyond motor dysfunction, PD contributes to respiratory impairment through muscle weakness, and airway obstruction. Respiratory failure, a major global health burden, is increasingly recognized as a significant cause of fatality in advanced PD.

We analyzed PD (ICD-10 code: G20) and respiratory failure (ICD-10 code: J96)-related mortality in older adults, using the CDC-WONDER database from 1999 to 2020. Age-Adjusted Mortality Rates (AAMR) per 100,000 were calculated and categorized by demographics and region. Joinpoint regression was used to estimate Annual Percent Change and Average Annual Percent Change (AAPC).

A total of 59,168 PD and respiratory failure-related deaths were recorded among older adults aged ≥65 years. The AAMR observed a significantly steep incline from 5.5 in 1999 to 11.38 in 2020 (AAPC: 3.10%; 95% CI: 2.01 to 4.20, p < 0.01). Men demonstrated higher overall AAMR than women. Among different races and ethnicities, Non-Hispanic White population had the highest overall AAMR. Regionally, the highest overall AAMR was recorded in the West and Metropolitan areas.

This study highlights a marked rise in PD and respiratory failure-related deaths in the United States, with notable disparities across demographics and regions. Mortality was higher in males and non-Hispanic Whites, with the West and urban areas showing sharp increases, reflecting limited access to special care. These findings underscore widening inequities and the need for targeted policies, equitable resource allocation, and further research on underlying social and healthcare determinants.