Objective: To estimate mortality, standardized mortality ratios (SMRs), causes of death, and survival-related risk factors in a large, multicenter Parkinson’s disease (PD) cohort from the Chinese Parkinson’s Disease Registry (CPDR).

Background: PD is the second most common neurodegenerative disorder and the fastest-growing neurological cause of disability worldwide.

Method: The CPDR consecutively enrolled patients (January 2018–December 2020) from 19 tertiary hospitals in China. Clinical assessments and genotyping were performed. Vital status and causes of death were verified using medical records, death certificates, and family reports, coded by ICD-10. Follow-up continued through December 31, 2024. Descriptive analyses were used to summarize baseline characteristics and SMRs were calculated for the cohort. Survival analysis were evaluated using multivariable Cox proportional hazards models with time since disease onset as the time scale and left truncation (late entry) to reduce immortal time bias. Kaplan–Meier analyses and restricted cubic splines were used to further assess survival patterns and potential non-linear associations.

Results: Among 3,148 patients, 562 deaths occurred over a mean follow-up of 5.89 ± 1.90 years, corresponding to a mortality density of 3.03 deaths per 100 person-years. Median survival from disease onset was 23.33 years, and the overall SMR was 1.33. Cardiovascular disease was the leading cause of death (29.36%), followed by cerebrovascular disease (17.62%) and respiratory disease (16.90%) (Figure 1). In multivariable analyses (Figure 2), higher mortality risk was associated with older age at onset, glucocerebrosidase (GBA1) gene variants, type 2 diabetes, higher levodopa equivalent daily dose (LEDD), advanced Hoehn and Yahr stage, higher Unified Parkinson’s Disease Rating Scale Part III (UPDRS III) scores, a history of falls, cognitive dysfunction, and depression. Higher educational attainment and deep brain stimulation (DBS) surgery were associated with a lower risk of death. Kaplan–Meier curves demonstrated subgroup differences (Figure 3A–J), and UPDRS III showed a non-linear positive association with mortality risk (Figure 3K).

Conclusion: This nationwide CPDR analysis provides mortality rates, SMRs, causes of death, and key predictors of survival in Chinese PD, supporting risk stratification and patient counseling.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/survival-and-related-factors-in-patients-with-parkinsons-disease-a-multicenter-prospective-cohort-study-in-china/