Objective: To evaluate comorbidity prevalence in Parkinson’s disease (PD) and its impact on fracture risk, socioeconomic burden, and overall survival.

Background: PD patients frequently present with multiple comorbidities. While their effect on mortality is known, the combined impact on socioeconomic costs and complication trajectories—especially regarding how severe immobility alters these risks—remains under-investigated.

Method: : A retrospective cohort study was conducted using the Korean National Health Insurance database (2010–2024), identifying 273,398 PD patients (ICD-10: G20). Comorbidity prevalence ratios (PR) were compared against the 2015 general population. Cox proportional hazards models analyzed time to fracture and overall survival. Healthcare expenditures were evaluated based on comorbidity count and the Charlson Comorbidity Index (CCI).

Results: PD patients exhibited a significantly higher multimorbidity burden, particularly in neurological and cerebrovascular domains, compared to the general population. Fracture risk increased with up to 5 comorbidities but paradoxically attenuated with ≥6, likely because severe immobility limits fall exposure. In contrast, mortality showed a strict linear dose-response relationship, peaking at ≥6 comorbidities (HR 1.23). Economic burden amplified exponentially, with annual medical costs exceeding 100 million KRW for the ≥6 comorbidities group.

Conclusion: PD is a systemic condition with a comorbidity burden far exceeding the general population. Severe multimorbidity masks fracture risk due to immobility but directly shortens survival and exponentially increases costs. These findings highlight the critical need to shift PD management from single-disease symptom control to an integrated care model encompassing systemic comorbidities.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impact-of-comorbidities-on-clinical-outcomes-and-socioeconomic-burden-in-parkinsons-disease-a-10-year-nationwide-cohort-study/