Objective: To identify independent risk factors of mortality in a community-based Parkinson´s disease (PD) cohort during prospective long-term follow-up. Specifically, we analized the effect of motor complications and others of therapy vs non-motor symptoms (NMS) burden on mortality.

Background: PD is a complex disorder in which patients develop along the progression of disease motor complications and different NMS. Mortality is increased in PD patients and in order to act preventively the soonest when it is possible, it is necessary to identify predictors of mortality.

Methods:

One hundred and forty seven non-demented PD patients (57.1 % males; 70.9 ± 8.6 years old) were included in this 48 month follow-up (from 2012 to 2016), longitudinal, single, evaluation study. Motor complications and others of therapy were assessed using the UPDRS-IV (Unified Parkinson´s Disease Rating Scale / part-IV). NMSS (Non-Motor Symptoms Scale) total score was ussed to assess NMS burden. Cox proportional hazards models were applied to identify independent predictors of mortality during follow-up.

Results:

Twenty-two patients of 146 (15.1%) died (1 case without information). UPDRS-IV and NMSS total score were higher at baseline in PD patients who died (3.5 ± 3.1 vs 2.4 ± 2.4 [p = 0.049] and 96.9 ± 58.6 vs 61.9 ± 51.0 [p = 0.004], respectively). Unajusted hazard ratio (HR) associated to UPDRS-IV and NMSS total score to die during follow-up were 1.171 (95% CI, 1.012-1.357; p = 0.035) and 1.008 (95% CI, 1.002-1.013; p = 0.006), respectively. Independent predictors of mortality during follow-up after other covariates adjustment were UPDRS-IV (HR 1.224 for 1 unit increase; 95% CI, 1.002-1.494; p = 0.047), age (HR 1.231 for year increase; 95% CI, 1,104-1.374; p < 0.0001) and comorbidity (HR 1.429 for 1 unit increase in Charlson Index score; 95% CI, 1.023-1.994; p = 0.036) but not NMSS total score (HR 1.005 for 1 unit increase; 95% CI, 0.996-1.014; p = 0.263).

Conclusions:

Motor complications and others of therapy (UPDRS-IV) but not non-motor symptoms burden (NMSS total score) predict short-term mortality in non-demented PD patients.

References: de Lau LM, Verbaan D, Marinus J, van Hilten JJ. Survival in Parkinson’s disease. Relation with motor and non-motor features. Parkinsonism Relat Disord 2014;20:613-6.

Williams-Gray CH, Mason SL, Evans JR, Foltynie T, Brayne C, Robbins TW, Barker RA. The CamPaIGN study of Parkinson’s disease: 10-year outlook in an incident population-based cohort. J Neurol Neurosurg Psychiatry 2013;84:1258-64.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/motor-complications-and-others-of-therapy-but-not-non-motor-symptoms-burden-predict-short-term-mortality-in-non-demented-parkinsons-disease-patients/