Objective: We aimed to analyse the major cause and contributory reasons for death in patients with Parkinson’s disease (PD) who were known to our PD service at Northampton General Hospital.

Background: PD is a progressive neuro-degenerative disorder associated with a decreased lifespan particularly for patients with dementia, a significant non motor feature. The current data provides little information for the cause of death in Parkinson’s disease. Aspiration pneumonia is often considered a leading cause of death in such patients.

Methods: An observational study was done on a series of 40 consecutive cases of patients with PD had been seen in the PD clinic previously by the Geriatric Medicine service at Northampton General Hospital between 2013 and 2015 and had subsequently died. The cause of death was obtained from the death certificates, hospital records and GP records. We also obtained data on the prior preferences of place of death and the actual place of death.

Results: The age range varied from 70 to 95 years with 62% male and 38% females. The mean Hoehn and Yahr score at the time of death was 3.66. 60% of these patients were aged from 80-89 years with 20% being very old at above 90 years.

The cause of death in was found to be PD related in 47% of patients with cancer, cardiovascular disease and bowel obstruction as rare causes.  71% of patients with PD related causes had aspiration pneumonia as the main cause of death. 12% had dementia as the cause of death. Preferred place of death was documented in only 38 % of patients and 57% actually died in the hospital.

Conclusions: It can be concluded that most patients with PD died of problems like aspiration pneumonia which was directly caused by PD rather than the PD itself.  We also found that Advanced Care Planning was happening for only a very small proportion of Parkinson’s patients known to the Northampton General Hospital clinic.

There was also a high of incidence of dementia in this cohort of patients who died with aspiration pneumonia. There were very few cardiac, strokes, and cancer causes of death.

Early swallow assessment after an acute admission in these patients would be the best practice. Offering Advance care planning in the clinic to discuss swallowing issues, future hospitalisations and preferred place of death would help to avoid these deaths in the acute hospital setting.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/death-in-patients-with-parkinsons-disease-an-observational-study/