INVESTIGADORES
PEREZ LLORET Santiago
congresos y reuniones científicas
Título:
Mortality rate in Parkinsons Disease. Preliminary results from the French PARKMIP/COPARK cohort after 24-months follow-up.
Autor/es:
LAURENCE NEGRE-PAGES; SANTIAGO PEREZ-LLORET; OLIVIER RASCOL
Lugar:
Paris, Francia
Reunión:
Congreso; Congreso Internacional de Movimientos Anormales; 2009
Resumen:
Bakground: Little is know on mortality and cause
of death in Parkinsons disease (PD). Most available studies do not allow comparisons with control groups and
are limited to specialized tertiary centers. These studies have shown an increased mortality rate
as compared to the general population.
Objective: To compare the mortality rate after 24-months of
follow up between PD patients recruited in academic as well as non-academic
neurological outpatient clinics and a group of age- and sex-matched healthy
controls recruited in general practitioners outpatient clinics. To describe
the clinical characteristics of deceased and non-deceased
PD patients.
Methods: 329 non-demented (MMSE >24)
idiopathic PD patients and 73 non-PD patients were recruited in the
PARKMIP/COPARK cohort and seen at baseline and 24 months. At both visits, PD
patients underwent standardized clinical examination, performed by the
neurologist to assess PD (UPDRS, H&Y, treatments). Self-administered
questionnaire was completed by the patient including the Hospital Anxiety and
Depression Scale (HADS) and quality of life questionnaire (PDQ39). Information
on drug consumption was also collected during the visit. Non-PD patients were
assessed in the same way except for PD features. Information about death and
its possible cause was collected by direct phone interview of patients caregiver
and referent physician of those who did not attend their planned 24-month
visit. Mortality rate was compared between these 2 groups. Clinical
characteristics of deceased and non deceased PD patients were also compared and
causes of death were analyzed. All data were controlled, validated and analyzed
centrally using SAS software version 9.2.
Results: 19 out of the 329 patients (5.8%)
and none of the non-PD patients died during the 24-months follow up period. Relative
risk for mortality was 4.27 and risk difference was 5.4% (95%CI= -2.1% ; -9.4%).
When comparing deceased and non deceased PD patients, the former had older age at
baseline (77±8 years vs 69±9 years, p=0.001), lower MMSE (26.6±2.1 vs 28.2±2.1,
p=0.001), and higher UPDRS II+III (39.7±19.9 vs 27.5±14.8, p=0.001) scores. Major
reported causes of mortality were cardiovascular diseases (32%); cancer
(21%); worsening of parkinsonism (16%); Suicide (1%) and unknown (26%).
Conclusion: PD patients had significantly higher mortality
rate as compared to non PD patients. Mortality rates was higher in older
patients with lower MMSE score and greater PD severity.