Objective: To investigate how clinical, motor and behavioural characteristics impact on Parkinson mortality in a cohort from a tertiary movement disorders specialty center .

Background: Parkinson’s disease (PD) is a neurodegenerative disorder with variable progression and shorter life-expectancy. However, the relevance of PD specific clinical manifestations and comorbidities is still debated [1].

Method: From a cohort of 108 PD patients followed at the Movement Disorders Unit of Padua University Hospital from diagnosis to death, we included 25 patients who had a detailed clinical assessment within 5 years from motor onset. Clinical assessment included MDS-UPDRS, a complete behavioural and neuropsychological evaluation allowing second level cognitive diagnosis and a comorbidity index (CCI). Patients were divided in two groups according to the interval from motor onset to death, respectively PD >10 years (n=12) and PD<10 years (n=13).

Results: Age, sex and CCI did not differ between the two groups. PD<10 years had lower MoCA score and more severe clinically relevant apathy and state anxiety traits (p<0.01) at visit compared with  PD >10 years (p<0.05). PD<10 years had more sever disease and higher MDS-UPDRS III scores especially bradykinesia (p<0.05).

Relevant differences(p<0.05) were found in dopamine-agonist use. Patients with PD<10 years were prescribed either no agonists or lower doses.

Conclusion: From the deeper characterization of our small PD patients’ cohort, we observed that the subgroup who died within 10 years from motor onset, presented worse motor, behavioral and cognitive profile. However, they did not differ in terms of comorbidity. These data support the concept of faster and slower progressing PD [3].

References: [1] Okunoye O, Horsfall L, Marston L, Walters K, Schrag A. Mortality of People with Parkinson’s Disease in a Large UK-Based Cohort Study: Time Trends and Relationship to Disease Duration. Mov Disord. 2021 Dec;36(12):2811-2820.
[2] Antonini, A., Bravi, D., Sandre, M., & Bubacco, L. (2020). Immunization therapies for Parkinson’s disease: state of the art and considerations for future clinical trials. Expert opinion on investigational drugs, 29(7), 685-695.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/predictors-of-death-in-parkinsons-disease/