Objective: to study the impact of modern pharmacotherapy of Parkinson’s disease (PD) on the main causes of death.
Background: the modern era of the use of antiparkinsonian drugs began with the publication of the positive effect of levodopa by D. Cotzias in 1967 [1]. Questions about the effect of therapy on life expectancy, the main causes of death in patients with PD remain controversial. The fundamental work of M. Hoehn and M. Yahr in 1967 [2], not only gave a classical description of the stages of PD, but also presented the main causes of fatal outcomes of patients with PD in the era before the use of modern medicines, which allows us to conduct a comparative analysis of similar criteria at the present time.
Method: a retrospective analysis of the medical records of 1754 patients with PD for 2011-2018, including 814 (46.4%) men and 940 (53.6%) women, as well as a comparative statistical analysis of the causes of deaths in the study group with a sample of M. Hoehn and M. Yahr. All patients of the study received therapy according to their age and stage of the disease.
Results: 156 people died during the follow – up period [table1]. The causes of death: cardiovascular diseases, oncology, respiratory diseases, digestive diseases-continue to be leading in patients with PD against the background of modern therapy, as well as in the group of M. Hoehn and M. Yahr.
In modern patients, the risk of mortality from circulatory diseases is 2.0 times higher (p<0.01), from diseases of the digestive system – 6.4 times (p<0.01) compared to the group of patients with M. Hoehn and M. Yahr. At the same time, the likely increased chance of death from respiratory diseases is 2.38 times less (p<0.02) in the XXI century [figure1].
There was no significant difference in mortality from diseases associated with neoplasms, however, its high percentage in the overall structure of mortality was noted, both in our study (13.0%) and according to the results of M. Hoehn and M. Yahr (12.1%) at p>0.05 [figure1].
Conclusion: the main causes of death of patients with PD in this study coincide with the causes of death of patients in the sample presented by M. Hoehn and M. Yahr in 1967, in the era before the use of modern antiparkinsonian drugs. Modern antiparkinsonian drugs can have both positive and probably negative effects on a patient with PD, increasing the likely risk of death.
References: 1. Cotzias GC, Van Woert MH, Schiffer LM. Aromatic amino acids and modification of parkinsonism. N Engl J Med. 1967 Feb 16;276(7):374-9. doi: 10.1056/NEJM196702162760703. PMID: 5334614. 2. Hoehn MM, Yahr MD. Parkinsonism: onset, progression and mortality. 1967. Neurology. 2001; 17(10 Suppl 3):S11-26.
To cite this abstract in AMA style:
S. Shtaimets. Causes of deaths in patients with Parkinson’s disease in the era before the use of modern drug therapy and at the present time [abstract]. Mov Disord. 2021; 36 (suppl 1). https://www.mdsabstracts.org/abstract/causes-of-deaths-in-patients-with-parkinsons-disease-in-the-era-before-the-use-of-modern-drug-therapy-and-at-the-present-time/. Accessed June 15, 2025.« Back to MDS Virtual Congress 2021
MDS Abstracts - https://www.mdsabstracts.org/abstract/causes-of-deaths-in-patients-with-parkinsons-disease-in-the-era-before-the-use-of-modern-drug-therapy-and-at-the-present-time/