Mortality rate in Parkinson’s Disease. Preliminary results from the French PARKMIP/COPARK cohort after 24-months follow-up.

LAURENCE NEGRE-PAGES; SANTIAGO PEREZ-LLORET; OLIVIER RASCOL

Paris, Francia

Congreso; Congreso Internacional de Movimientos Anormales; 2009

Bakground: Little is know on mortality and cause of death in Parkinson’s 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.