Objective: To examine the trends and impact of COVID-19 on Parkinson’s disease (PD) mortality stratified by gender, race and region among older adults in the United States (US) from 1999 to 2023.

Background: Chronic diseases like Parkinson’s were profoundly impacted during the COVID -19 pandemic causing significant morbidity and mortality. Potential disparities in geographical and demographic variables are important in determining patient outcomes.

Method: Analysis of data from Centers for Disease Control and Prevention’s Wide-ranging Online Data for Epidemiologic Research (CDC WONDER) death certificates (1999-2023) of adults ≧65 years, with Parkinson’s was done. To assess the impact of COVID-19, we divided the study period into three phases: pre-COVID (1999–2019), the COVID year (2020), and the post-COVID period (2021–2023). The annual percentage change (APC) in Age-adjusted mortality rates (AAMR) per 100,000 was calculated using Joinpoint regression.​

Results: During the study period, a total of 770,157 PD-related deaths occurred in the pre-COVID phase, 61,636 during the COVID year, and 172,599 in the post-COVID period. Analysis of AAMR revealed a sharp increase from 89.8 to 119.6 upon entering the COVID year, followed by a moderate decline to 111.1 in the post-COVID phase. Within the pre-COVID period, four distinct fluctuations were observed, including a significant decline between 2005 and 2009 and a notable increase between 2014 and 2018.​ Joinpoint regression analysis estimated an APC of 6.99 (95% CI: 1.28–13.02) from 2018 to 2021, covering the pre-defined COVID period. Males consistently exhibited higher AAMR than females across all timeframes. However, pairwise comparisons across segmented periods were not statistically significant (p = 0.066), suggesting a similar trend of change between sexes.​ Among racial groups, White individuals had the highest overall AAMR (102.5), followed by American Indians/Alaska Natives (64.9). Regionally, the Midwest had the highest AAMR (102.7), followed by the West (99.5).​

Conclusion: Parkinson related mortality has increased in the last few years especially since COVID-19. Reflecting on these trends and findings offer insights into mortality patterns and can help with public health interventions for patients with PD.

Deaths stratified by region from 1999-2023

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MDS Abstracts - https://www.mdsabstracts.org/abstract/temporal-trends-in-parkinsons-disease-related-mortality-from-1999-2023-a-national-analysis-pre-and-post-covid/