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Mortality and Parkinson disease

A community based study

From the Departments of Neurology (Drs. Herlofson and Larsen) and Psychiatry (Dr. Årsland), Central Hospital of Rogaland, Stavanger; and the Department of Public Health and Primary Health Care (Dr. Lie), Section for Medical Statistics, University of Bergen, Norway.

Address correspondence and reprint requests to Professor Jan P. Larsen, Department of Neurology, Central Hospital of Rogaland, Postbox 8100, N-4068 Stavanger, Norway; e-mail: jpl{at}sir.no

Objective: To compare the mortality of a community-based cohort of patients with carefully diagnosed Parkinson disease (PD) with the mortality in an age-matched population from the same study area and to investigate the possible influence of clinical features and diagnostic accuracy on survival in PD.

Methods: A total of 245 patients with PD were identified and included in the study. Patients were classified into groups of clinical definite, probable, and possible PD. The study period was 8 years. A total of 142 patients died. The mortality rates for the Norwegian population, which were available in 1-year intervals for all birth cohorts and both sexes during the study period, were used as controls.

Results: The standardized mortality ratio (SMR) for the total patient group was 1.52. The mortality rate was increased for both sexes (male SMR = 1.54, female SMR = 1.49) and in all age groups at disease onset (<60 years SMR = 1.92, 60 to 70 years SMR = 1.50, >70 years SMR = 1.41). The survival of patients with clinical definite PD was only modestly reduced (SMR = 1.35), whereas the SMR for possible PD was as high as 1.99.

Conclusions: Our study gives evidence for increased mortality in PD despite modern treatment. The increase is not extensive in patients with a high probability for idiopathic PD.

Received June 24, 2003. Accepted in final form November 26, 2003.

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