Inclusion And Exclusion Criteria
We excluded all people with a history of PD and those with restless leg syndrome without PD who were treated with dopamine agonists. In addition, individuals with diagnosis in the first 6months after registration with a practice were excluded because they could represent a recording of medical information which may be retrospective rather than a true new recording of PD. For the analysis on time trends and disease duration, we started the study period 1year from the index date only for those entering before and during 2007 to avoid follow-up time being too short for deaths to occur .
The PD Cohort consisted of all adults aged 50+years with first ever diagnosis Read code for PD and at least two prescriptions of any of five major classes of antiparkinsonian medications , in which there is an overlap with THIN in about 60% of patients. This same case definition has been used in a previous study. Read code lists to identify electronic recording of PD diagnosis and drug code lists to identify the five major classes of antiparkinsonian medications were created using published guidelines.
The General Population comprised a frequency-matched random sample of up to six people with no record of PD. The non-PD cohort was frequency-matched within each practice on age, gender, and calendar year using a randomly assigned index date.
Death Rate From Parkinson’s Rising In Us Study Finds
- Date:
- American Academy of Neurology
- Summary:
- A new study shows that in the last two decades the death rate from Parkinson’s disease has risen about 63 percent in the United States. The study also found that the death rate was twice as high in men as in women, and there was a higher death rate in white people than other racial/ethnic groups.
A new study shows that in the last two decades the death rate from Parkinson’s disease has risen about 63% in the United States. The research is published in the October 27, 2021, online issue of Neurology®, the medical journal of the American Academy of Neurology. The study also foundthat the death rate was twice as high in men as in women, and there was a higher death rate in white people than other racial/ethnic groups.
“We know that people are living longer and the general population is getting older, but that doesn’t fully explain the increase we saw in the death rate in people with Parkinson’s,” study author Wei Bao, MD, PhD, who conducted the research at the University of Iowa in Iowa City. “Understanding why more people are dying from this disease is critical if we are going to reverse the trend.”
The study looked at a national death registry that included 479,059 people who died of Parkinson’s between 1999 and 2019.
After adjusting for age, researchers found that the number of people who died from the disease increased from 5.4 per 100,000 people in 1999 to 8.8 per 100,000 people in 2019. The average annual increase was 2.4%.
Caring For Your Health With Parkinson’s Disease
In addition to caring for your Parkinson’s health, it is also important to care for your overall health. This means visiting your primary care physician periodically for preventive care like the annual flu shot and cancer screeningsfor example, a mammogram for breast cancer screening and a colonoscopy for colon cancer screening.
A primary care physician can also evaluate for risk factors related to heart attacks and strokes, and provide counseling on exercise, smoking, alcohol use, depression, or other mental health concerns. Regular visits to your primary care physician or neurologist will also allow them to catch bacterial infections like urinary tract infections before they get serious.
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Pd Death Rates Rising Study
According to a recent report based on nationwide mortality data, the death rate from Parkinsons disease in the United States has significantly risen by 63 percent over two decades.
In the same period between 1999 and 2019 men died from the disease by twice as much as women. A higher mortality rate was also seen among white people compared to other individuals from different racial and ethnic backgrounds.
We know that people are living longer and the general population is getting older, but that doesnt fully explain the increase we saw in the death rate in people with Parkinsons, Wei Bao, MD, PhD, the studys lead author and an associate professor in the department of epidemiology at the University of Iowas College of Public Health, said in a press release.
Complications Related To Parkinson’s Can Affect Survival
Claudia Chaves, MD, is board-certified in cerebrovascular disease and neurology with a subspecialty certification in vascular neurology.
Parkinson’s is a common neurodegenerative disease, and although it is not fatal, research suggests it may influence life expectancy.
A 2012 study in Archives of Neurology examined the six-year survival of nearly 140,000 Medicare beneficiaries with Parkinson’s disease in the United States. During the six-year period, 64% of the participants with Parkinson’s disease passed away.
The risk of death of those with Parkinson’s was then compared to Medicare beneficiaries who did not have Parkinson’s or any other common diseases, including:
When controlling for variables like age, race, and gender, the six-year risk of death among people with Parkinson’s was found to be nearly four times greater than those Medicare beneficiaries without the disease or other common diseases.
At the same time, the rate of death among those with Parkinson’s disease was similar to those with hip fracture, Alzheimer’s dementia, or a recent heart attackalthough it was higher than those who had been newly diagnosed with either colorectal cancer, stroke, ischemic heart disease, or chronic obstructive pulmonary disease.
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Baseline Characteristics And Descriptive Statistics Of Overall Survival
Four patients turned out to have disease other than PD on follow-up, leaving 129 for analyses. Median time between first PD diagnosis and baseline measurement was 3.3 months . Missing data occurred for LED , MMSE , and PD-MCI status . The majority of patients was male . Median age at baseline was 68.2 years , median UPDRS-III at baseline was 16 points , and 36.4% of patients had PD-MCI at baseline. LED was zero for 46 patients and the median for the remaining patients was 220mg . Therefore, the majority of patients was already on levodopa treatment, as started by their treating neurologist, before their baseline measurement. The minimum duration of follow-up conditional on survival was 13.0 years. The average and total duration of follow-up over all patients were 10.3 and 1327 years respectively. Eighty-five subjects died during follow-up. Median survival time was 11.8 years with a 95% confidence interval of 10.0 to 13.4. Figure 2 shows the Kaplan-Meier curve for the cohort, together with expected survival in the general population. The observed survival in PD was clearly lower than expected for the general population.
Fig.2
Survival in Parkinsons disease versus the general population. Kaplan-Meier curve for the cohort with 95% confidence interval versus the expected survival in the general population for the cohorts distribution of age and sex . The population curve is assumed known and therefore does not have a confidence interval.
What Is The Prevalence
It is important to understand the difference between incidence and prevalence. Incidence is the number of new cases of a disease that are diagnosed in a time period. Usually, incidence is the number of new cases per year.3
Prevalence is the number of cases of a disease that exist at any point in time. This number is larger because it includes new cases and all the existing cases of a disease.3
In 2014, the Parkinsons Foundation started a project to get a better measurement of PD prevalence. Currently, there are an estimated 1 million people in the United States living with PD. About 60,000 people in the United States are diagnosed each year with PD in the United States. Experts estimate there will be 1.2 million people in the United States living with PD by 2030.1,3
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How Did They Do This
Dr. Backstrom works at Umea University, in Sweden. He and his colleagues work in an area in northern Sweden where approximately 142,000 people live. Umea University is the main medical center in this region, and most of the people who live there are referred to Umea University. In order to better understand the connection between PD and early death, Dr. Backstrom enrolled only people who had early PD and who were not yet taking medication for this. People were enrolled between January 1, 2004, and April 30, 2009, and were followed until August 31, 2017. Dr. Backstrom identified 182 people with symptoms of early PD.
In the study, many tests were done . All of the participants had neurologic examinations, filled out questionnaires, and had neuropsychological testing. Not everybody had the other tests . The first test was a detailed neurologic examination in order to confirm and firmly establish the diagnosis of PD. This is essential because there are several illnesses that are very similar to PD, and Dr. Backstrom wanted to be sure that the diagnosis was as precise as possible. Of the 182 patients, Dr. Backstrom found that 143 had classic PD, 13 had a similar disease called multiple system atrophy , and 18 had progressive supranuclear palsy . The other 8 had an unclear diagnosis or simply did not have PD.
Tests performed
The study was designed to look at the association of mortality with PD. During the study, 109 people died. For 98 of these , a cause of death was known.
Large Study Finds Parkinson Disease Us Death Rate Soared 63% Over 20 Years
The authors said long-term trends in Parkinson disease were previously unknown and that the findings are important to determining national health care priorities.
The death rate from Parkinson disease has risen about 63% in the United States over the past 2 decades, according to a study released Thursday.
Although the increase was regardless of age, sex, race/ethnicity, urban-rural classification, and geographic location, some groups were affected more than othersnamely men and White individuals. In addition, city residents had higher death rates than rural ones.
The authors, writing in Neurology, said it is the most comprehensive study to date on the issue, that long-term trends were previously unknown, and that the findings are key to determining health care priorities, including financing and research.
In the United States, about 1 million individuals have PD, and nearly 60,000 new cases are diagnosed each year.
The investigators used data on 479,059 deaths due to PD from 1999 to 2019 from the National Vital Statistics System , a nationwide, population-based death registry. More than 99% of US deaths are recorded in the database, which is part of the CDCs National Center for Health Statistics.
After adjusting for age, the researchers found that the number of people who died from the disease increased from 5.4 per 100,000 people in 1999 to 8.8 per 100,000 people in 2019. The average annual increase was 2.4%.
Reference
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Death Rate From Parkinsons Disease Rising In The Us
Over the last two decades, the death rate from Parkinson’s disease has risen about 63% in the US, according to research published in Neurology, the medical journal of the American Academy of Neurology. The study also reported that the death rate was twice as high in men as in women, and there was a higher death rate in white people than other racial/ethnic groups.
“We know that people are living longer and the general population is getting older, but that doesn’t fully explain the increase we saw in the death rate in people with Parkinson’s,” study author Wei Bao, MD, PhD, who conducted the research at the University of Iowa in Iowa City. “Understanding why more people are dying from this disease is critical if we are going to reverse the trend.”
The study looked at a national death registry that included 479,059 people who died of Parkinson’s between 1999 and 2019.
After adjusting for age, researchers found that the number of people who died from the disease increased from 5.4 per 100,000 people in 1999 to 8.8 per 100,000 people in 2019. The average annual increase was 2.4%.
It’s important to continue to evaluate long-term trends in Parkinson’s death rates, said Dr. Bao. This can inform future research that may help pinpoint why more people are dying of the disease. Also, updating vital statistics about Parkinson’s death rates may be used for priority setting and financing of health care and policy.”
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The Last Year Of Life In Parkinson’s Disease
The study also examined nearly 45,000 hospitalizations in people with terminal Parkinson’s, meaning their end-of-life period.
Of those with terminal PD, the most common reasons for being in the hospital were:
- Infection
- Heart disease
- Lung disease that was not from an infection
Less common causes for hospitalization were problems related to the stomach or intestines, muscles, nervous system, or endocrine system .
It is not surprising that infection was the most common hospitalization before death, as people with Parkinson’s are vulnerable to developing a number of infections as a result of their disease. For example, bladder dysfunction in Parkinson’s increases a person’s risk of developing urinary tract infections, which can become life-threatening if not detected and treated promptly.
In addition, research suggests that aspiration pneumonia is 3.8 times more common in people with Parkinson’s as compared to the general population. It has also been consistently reported to be the main cause of death in people with Parkinson’s.
Aspiration pneumonia results from underlying swallowing difficulties, which leads to stomach contents being inhaled into the lungs. Immobilization and rigidity, which can impair phlegm removal, also contribute to the development of pneumonia in people with Parkinson’s.
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Overall Mortality Modeling Results
Results of survival analyses for overall and PD-related mortality are shown in Table 1. Overall mortality increased significantly with increasing age, male sex, higher LED, and presence of PD-MCI at baseline. The global test for non-linear contributions was non-significant . Schoenfeld residual indicated some possible deviation from the assumption of proportional hazards for sex, UPDRS-III Levy B and PD-MCI as shown in Fig. 3. However, these deviations were considered insufficient to warrant a more complex model. As a check, a model stratified on sex was also fitted, which rendered very similar results with all estimates less than half a standard error from the reported model . The observed and bootstrap corrected C-statistic were 0.79 and 0.77 respectively, indicating good discriminative performance. Since LED relates to motor symptom severity as measured by the UPDRS-III, its presence in the model might mask the effect of motor symptom severity. A post-hoc analysis was conducted to evaluate whether this was the case. Removing LED from the model revealed a significantly increased risk of mortality for higher UPDRS-III Levy B score . The estimates of other coefficients and their significance level were very similar to the full model, including the estimated coefficient for UPDRS-III Levy A score.
Table 1
Multivariable Cox model evaluating the hazard of mortality
| UPDRS-III Levy A | 0.01 |
| UPDRS-III Levy B | 0.05 |
| 3.10 | 0.02 |
Fig.3
Table 2
| 2.10 | 0.036 |
What Are The Management Options For Canadians Living With Parkinsonism
There is currently no cure for Parkinsons disease and most other parkinsonism cases. However, treatment options are available to help mitigate the symptoms and health impacts associated with these conditions. Most often the primary treatment is pharmacological, but it may also include other therapeutic options and, in the case of Parkinsons disease, surgical interventions. Studies have shown that specially tailored exercise programs, supervised by physiotherapists or other trained professionals, may help affected individuals maintain or improve their physical functionality and general well-being.Footnote 2 Footnote 3 Footnote 4 Footnote 5
Box 1: What’s in the data?
The data used in this publication are from the Canadian Chronic Disease Surveillance System , a collaborative network of provincial and territorial chronic disease surveillance systems, led by the Public Health Agency of Canada . The CCDSS identifies chronic disease cases from provincial and territorial administrative health databases, including physician billing claims and hospital discharge abstract records, linked to provincial and territorial health insurance registry records using a unique personal identifier. Data on all residents eligible for provincial or territorial health insurance are captured in the health insurance registries.
Definition of diagnosed parkinsonism, including Parkinsons disease, in the CCDSS
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Overall And Disease Related Mortality In Parkinsons Disease A Longitudinal Cohort Study
Article type: Research Article
Authors: Hoogland, Jeroena * | Post, Bartb | de Bie, Rob M.A.a
Affiliations: Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Meibergdreef, AZ Amsterdam, The Netherlands | Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behavior, Nijmegen, The Netherlands
Correspondence: Correspondence to: Jeroen Hoogland, Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam Neuroscience, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands. Tel.: +31 20 5666822 E-mail: .
Keywords: Parkinson disease, mortality, cohort studies, survival analyses
DOI: 10.3233/JPD-191652
Journal: Journal of Parkinson’s Disease, vol. 9, no. 4, pp. 767-774, 2019
Abstract
Parkinson’s Death Rate Rising Reasons Unclear
Megan Brooks
The death rate from Parkinson’s disease has increased about 63% over the past two decades in the United States, according to what the investigators say is the most comprehensive study of temporal trends in PD mortality in the United States.
“The reason behind the rising death rates from PD is not clear at present and warrants further investigation,” Wei Bao, MD, PhD, with the University of Iowa, in Iowa City, told Medscape Medical News.
“We know that people are living longer and the general population is getting older, but that doesn’t fully explain the increase we saw in the death rate in people with Parkinson’s,” Bao added in a statement.
“Understanding why more people are dying from this disease is critical if we are going to reverse the trend,” Bao said.
The study was October 27 in Neurology.
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