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Mortality from Parkinson's disease: A population-based prospective study (NEDICES)§

Authors

  • Ignacio J. Posada MD, PhD,

    1. Department of Neurology, University Hospital “12 de Octubre,” Madrid, Spain
    2. Faculty of Medicine, Complutense University, Madrid, Spain
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  • Julián Benito-León MD, PhD,

    Corresponding author
    1. Department of Neurology, University Hospital “12 de Octubre,” Madrid, Spain
    2. Faculty of Medicine, Complutense University, Madrid, Spain
    3. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
    • Avda. de la Constitución 73, portal 3, 7° Izquierda, E-28821 Coslada, Madrid, Spain
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  • Elan D. Louis MD, MSc,

    1. G.H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    3. Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    4. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York, USA
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  • Rocío Trincado MA,

    1. Department of Neurology, University Hospital “12 de Octubre,” Madrid, Spain
    2. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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  • Alberto Villarejo MD,

    1. Department of Neurology, University Hospital “12 de Octubre,” Madrid, Spain
    2. Faculty of Medicine, Complutense University, Madrid, Spain
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  • María José Medrano MD, PhD,

    1. Unit of Vascular Risk Factors, National Center for Epidemiology, ISCIII, Madrid, Spain
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  • Félix Bermejo-Pareja MD, PhD

    1. Department of Neurology, University Hospital “12 de Octubre,” Madrid, Spain
    2. Faculty of Medicine, Complutense University, Madrid, Spain
    3. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
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  • Funding agencies: This work was supported by FIS 93/0773 and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Spain.

  • Relevant conflicts of interest/financial disclosures: Julián Benito-León is supported by NIH R01 NS039422 from the National Institutes of Health (Bethesda, MD). Elan Louis is supported by R01 NS042859 and R01 NS039422 from the National Institutes of Health (Bethesda, MD). Félix Bermejo-Pareja is supported by NIH R01 NS039422 from the National Institutes of Health (Bethesda, MD).

  • §

    Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Most studies of mortality in Parkinson's disease have been clinical studies, yielding results that are not representative of the general population. We assessed the risk of mortality from Parkinson's disease in the Neurological Disorders in Central Spain (NEDICES) study, a prospective population-based study in which Parkinson's disease patients who were not ascertained through medical practitioners were also included. The cohort consisted of 5262 elderly subjects (mean baseline age, 73.0 years), including 81 with Parkinson's disease at baseline (1994–1995). Thirteen-year mortality was assessed. Two thousand seven hundred and one of 5262 subjects (51.3%) died over a median follow-up of 12.0 years (range, 0.04–14.8 years), including 66 of 81 subjects (81.5%) with Parkinson's disease at baseline and 2635 of 5181 subjects (50.8%) without Parkinson's disease at baseline. In an unadjusted Cox model, the hazard ratio of mortality was increased in subjects with Parkinson's disease (hazard ratio, 2.29; 95% confidence interval, 1.80–2.93; P < .001) versus subjects without Parkinson's disease (reference group). In a Cox model that adjusted for a variety of demographic factors and comorbidities, the risk of mortality remained elevated in subjects with Parkinson's disease (hazard ratio, 1.75; 95% CI, 1.32–2.31, P < .001). In additional Cox models, Parkinson's disease patients with dementia had particularly high risks of mortality (adjusted hazard ratio, 2.62; 95% CI, 1.40–4.90; P < .001). In this prospective population-based study, Parkinson's disease was an independent predictor of mortality in the elderly. Parkinson's disease patients with dementia had particularly high risks of mortality. © 2011 Movement Disorder Society

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