HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) Data Supplement Correspondence: Submit a response Alert me when this article is cited Alert me when Correspondence are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Marras, C. Search for Related Content PubMed PubMed Citation Articles by Marras, C. Related Collections Parkinson's disease/Parkinsonism Prognosis All epidemiology

Survival in Parkinson disease

Thirteen-year follow-up of the DATATOP cohort

From the Division of Neurology (Drs. Marras and Lang), Toronto Western Hospital, University Health Network, University of Toronto, Kunin-Lunenfeld Applied Research Unit (Dr. Rochon), Baycrest Centre for Geriatric Care, University of Toronto, Institute for Clinical and Evaluative Sciences (Dr. Rochon), Divisions of Clinical Decision Making and Health Care (Dr. Naglie), Toronto General Research Institute, University Health Network, Division of General Internal Medicine (Dr. Naglie), University Health Network, Geriatrics Program (Dr. Naglie), Toronto Rehabilitation Institute, and Departments of Medicine and Health Policy, Management, and Evaluation (Dr. Naglie), University of Toronto, Ontario, Canada; and Department of Biostatistics and Computational Biology (Dr. McDermott) and Clinical Trials Coordination Center (Dr. Rudolph), University of Rochester Medical Center, NY, and Parkinson’s Institute (Dr. Tanner), Sunnyvale, CA.

Address correspondence and reprint requests to Dr. C. Marras, Movement Disorders Centre, Toronto Western Hospital, 11-MP, 399 Bathurst St., Toronto, Ontario, Canada M5T 2S8; e-mail: connie.marras{at}utoronto.ca

Objective: To investigate predictors of survival in Parkinson disease (PD).

Methods: Vital status was determined in 800 subjects enrolled in a clinical trial of deprenyl (selegiline) and tocopherol 13 years earlier.

Results: Two hundred ninety-six deaths were recorded. There was no difference in the standardized mortality ratios across gender or age group. In univariate analyses, PD-specific variables associated with mortality were increased symmetry of parkinsonism, gait dysfunction as an initial symptom, severity of parkinsonism, and rate of worsening of parkinsonism prior to study enrollment. Cumulative exposure to deprenyl was not associated with mortality. In multivariable analysis, severity of parkinsonism and rate of worsening of parkinsonism remained associated with mortality. A poorer response to levodopa was associated with increased mortality independent of disease severity or dosage of levodopa. Results were unchanged when the analysis was restricted to 747 subjects maintaining a most likely diagnosis of PD throughout 6 years of active follow-up.

Conclusions: Parkinson disease did not affect survival differently across gender or age groups in this selected group of otherwise healthy clinical trial participants. Severity and rate of worsening of parkinsonism and response to levodopa are strongly related to survival.

Received March 16, 2004. Accepted in final form September 15, 2004.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the January 11 issue to find the title link for this article.

*See appendix E-1 on the Neurology Web site for a list of Group members.

This article has been cited by other articles:

				J. A. Driver, T. Kurth, J. E. Buring, J. M. Gaziano, and G. Logroscino Parkinson disease and risk of mortality: A prospective comorbidity-matched cohort study Neurology, April 15, 2008; 70(16_Part_2): 1423 - 1430. [Abstract] [Full Text] [PDF]

				L. S Ishihara, A. Cheesbrough, C. Brayne, and A. Schrag Estimated life expectancy of Parkinson's patients compared with the UK population J. Neurol. Neurosurg. Psychiatry, December 1, 2007; 78(12): 1304 - 1309. [Abstract] [Full Text] [PDF]

				G. Bjelakovic, D. Nikolova, L. L. Gluud, R. G. Simonetti, and C. Gluud Mortality in Randomized Trials of Antioxidant Supplements for Primary and Secondary Prevention: Systematic Review and Meta-analysis JAMA, February 28, 2007; 297(8): 842 - 857. [Abstract] [Full Text] [PDF]

				C. Marras, A. E. Lang, D. Oakes, M. P. McDermott, K. Kieburtz, I. Shoulson, C. M. Tanner, and S. Fahn High-Dosage Vitamin E Supplementation and All-Cause Mortality Ann Intern Med, July 19, 2005; 143(2): 152 - 153. [Full Text] [PDF]

				Minerva BMJ, April 16, 2005; 330(7496): E348 - E348. [Full Text] [PDF]

				Minerva BMJ, January 22, 2005; 330(7484): 204 - 204. [Full Text] [PDF]