Mortality in Parkinson's disease: a 20-year follow-up study.
Identifieur interne : 002563 ( Ncbi/Checkpoint ); précédent : 002562; suivant : 002564Mortality in Parkinson's disease: a 20-year follow-up study.
Auteurs : Anja Diem-Zangerl [Autriche] ; Klaus Seppi ; Gregor K. Wenning ; Eugen Trinka ; Gerhard Ransmayr ; Wilhelm Oberaigner ; Werner Poewe [Autriche]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2009.
English descriptors
- KwdEn :
- MESH :
- epidemiology : Parkinsonian Disorders.
- mortality : Parkinsonian Disorders.
- physiopathology : Parkinsonian Disorders.
- Age of Onset, Aged, Aged, 80 and over, Cause of Death, Female, Humans, Kaplan-Meier Estimate, Life Expectancy, Longitudinal Studies, Male, Retrospective Studies, Risk Factors.
Abstract
We determined mortality rates and predictors of survival in 238 consecutive patients with Parkinson's disease (PD) with symptom onset between 1974 and 1984. All patients were regularly followed at the Movement Disorder Clinic (Department of Neurology at the Innsbruck Medical University) until December 31, 2004, or death. As of December 31, 2004, 189 patients had died. Standardized mortality ratios (SMRs) increased over time. SMRs were 0.6 (95% CI 0.4-1.0) by 5 years, 0.9 (95% CI 0.7-1.2) by 10 years, 1.2 (95% CI 1.0-1.4) by 15 years, and 1.3 (95% CI 1.1-1.5) by 20 to 30 years. SMR for male patients was significantly increased to 1.3 (95% CI 1.1-1.6), whereas SMR increase of 1.2 (0.9-1.4) observed in female patients was not significant. Significantly increased SMRs were detected in patients with younger and older age of onset. Male gender, gait disorder, lack of tremor, and lack of asymmetry as presenting clinical features predicted poor survival in a Cox's proportional hazard analysis. This study demonstrates similar survival of patients with PD to the normal control population up to a disease duration of 10 years, followed by a modest rise of mortality with disease duration beyond 10 years compared with the general population. Under regular specialist care using all currently available therapies life expectancy in PD does not appear seriously compromised, but male gender, gait disorder, and absent rest tremor at presentation are associated with poorer long-term survival.
DOI: 10.1002/mds.22414
PubMed: 19224612
Affiliations:
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Wenning</name></author><author><name sortKey="Trinka, Eugen" sort="Trinka, Eugen" uniqKey="Trinka E" first="Eugen" last="Trinka">Eugen Trinka</name></author><author><name sortKey="Ransmayr, Gerhard" sort="Ransmayr, Gerhard" uniqKey="Ransmayr G" first="Gerhard" last="Ransmayr">Gerhard Ransmayr</name></author><author><name sortKey="Oberaigner, Wilhelm" sort="Oberaigner, Wilhelm" uniqKey="Oberaigner W" first="Wilhelm" last="Oberaigner">Wilhelm Oberaigner</name></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation><country>Autriche</country><placeName><settlement type="city">Innsbruck</settlement><region nuts="2" type="region">Tyrol (Land)</region></placeName><orgName type="university">Université de médecine d'Innsbruck</orgName></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PubMed</idno><date when="2009">2009</date><idno type="doi">10.1002/mds.22414</idno><idno type="RBID">pubmed:19224612</idno><idno type="pmid">19224612</idno><idno type="wicri:Area/PubMed/Corpus">001E14</idno><idno type="wicri:Area/PubMed/Curation">001E14</idno><idno type="wicri:Area/PubMed/Checkpoint">001D17</idno><idno type="wicri:Area/Ncbi/Merge">002563</idno><idno type="wicri:Area/Ncbi/Curation">002563</idno><idno type="wicri:Area/Ncbi/Checkpoint">002563</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en">Mortality in Parkinson's disease: a 20-year follow-up study.</title><author><name sortKey="Diem Zangerl, Anja" sort="Diem Zangerl, Anja" uniqKey="Diem Zangerl A" first="Anja" last="Diem-Zangerl">Anja Diem-Zangerl</name><affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, Innsbruck Medical University, Innsbruck, Austria.</nlm:affiliation><country xml:lang="fr">Autriche</country><wicri:regionArea>Department of Neurology, Innsbruck Medical University, Innsbruck</wicri:regionArea><wicri:noRegion>Innsbruck</wicri:noRegion></affiliation></author><author><name sortKey="Seppi, Klaus" sort="Seppi, Klaus" uniqKey="Seppi K" first="Klaus" last="Seppi">Klaus Seppi</name></author><author><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K" last="Wenning">Gregor K. Wenning</name></author><author><name sortKey="Trinka, Eugen" sort="Trinka, Eugen" uniqKey="Trinka E" first="Eugen" last="Trinka">Eugen Trinka</name></author><author><name sortKey="Ransmayr, Gerhard" sort="Ransmayr, Gerhard" uniqKey="Ransmayr G" first="Gerhard" last="Ransmayr">Gerhard Ransmayr</name></author><author><name sortKey="Oberaigner, Wilhelm" sort="Oberaigner, Wilhelm" uniqKey="Oberaigner W" first="Wilhelm" last="Oberaigner">Wilhelm Oberaigner</name></author><author><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name><affiliation><country>Autriche</country><placeName><settlement type="city">Innsbruck</settlement><region nuts="2" type="region">Tyrol (Land)</region></placeName><orgName type="university">Université de médecine d'Innsbruck</orgName></affiliation></author></analytic><series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title><idno type="eISSN">1531-8257</idno><imprint><date when="2009" type="published">2009</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Age of Onset</term><term>Aged</term><term>Aged, 80 and over</term><term>Cause of Death</term><term>Female</term><term>Humans</term><term>Kaplan-Meier Estimate</term><term>Life Expectancy</term><term>Longitudinal Studies</term><term>Male</term><term>Parkinsonian Disorders (epidemiology)</term><term>Parkinsonian Disorders (mortality)</term><term>Parkinsonian Disorders (physiopathology)</term><term>Retrospective Studies</term><term>Risk Factors</term></keywords><keywords scheme="MESH" qualifier="epidemiology" xml:lang="en"><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" qualifier="mortality" xml:lang="en"><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinsonian Disorders</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Age of Onset</term><term>Aged</term><term>Aged, 80 and over</term><term>Cause of Death</term><term>Female</term><term>Humans</term><term>Kaplan-Meier Estimate</term><term>Life Expectancy</term><term>Longitudinal Studies</term><term>Male</term><term>Retrospective Studies</term><term>Risk Factors</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">We determined mortality rates and predictors of survival in 238 consecutive patients with Parkinson's disease (PD) with symptom onset between 1974 and 1984. All patients were regularly followed at the Movement Disorder Clinic (Department of Neurology at the Innsbruck Medical University) until December 31, 2004, or death. As of December 31, 2004, 189 patients had died. Standardized mortality ratios (SMRs) increased over time. SMRs were 0.6 (95% CI 0.4-1.0) by 5 years, 0.9 (95% CI 0.7-1.2) by 10 years, 1.2 (95% CI 1.0-1.4) by 15 years, and 1.3 (95% CI 1.1-1.5) by 20 to 30 years. SMR for male patients was significantly increased to 1.3 (95% CI 1.1-1.6), whereas SMR increase of 1.2 (0.9-1.4) observed in female patients was not significant. Significantly increased SMRs were detected in patients with younger and older age of onset. Male gender, gait disorder, lack of tremor, and lack of asymmetry as presenting clinical features predicted poor survival in a Cox's proportional hazard analysis. This study demonstrates similar survival of patients with PD to the normal control population up to a disease duration of 10 years, followed by a modest rise of mortality with disease duration beyond 10 years compared with the general population. Under regular specialist care using all currently available therapies life expectancy in PD does not appear seriously compromised, but male gender, gait disorder, and absent rest tremor at presentation are associated with poorer long-term survival.</div></front></TEI><affiliations><list><country><li>Autriche</li></country><region><li>Tyrol (Land)</li></region><settlement><li>Innsbruck</li></settlement><orgName><li>Université de médecine d'Innsbruck</li></orgName></list><tree><noCountry><name sortKey="Oberaigner, Wilhelm" sort="Oberaigner, Wilhelm" uniqKey="Oberaigner W" first="Wilhelm" last="Oberaigner">Wilhelm Oberaigner</name><name sortKey="Ransmayr, Gerhard" sort="Ransmayr, Gerhard" uniqKey="Ransmayr G" first="Gerhard" last="Ransmayr">Gerhard Ransmayr</name><name sortKey="Seppi, Klaus" sort="Seppi, Klaus" uniqKey="Seppi K" first="Klaus" last="Seppi">Klaus Seppi</name><name sortKey="Trinka, Eugen" sort="Trinka, Eugen" uniqKey="Trinka E" first="Eugen" last="Trinka">Eugen Trinka</name><name sortKey="Wenning, Gregor K" sort="Wenning, Gregor K" uniqKey="Wenning G" first="Gregor K" last="Wenning">Gregor K. Wenning</name></noCountry><country name="Autriche"><noRegion><name sortKey="Diem Zangerl, Anja" sort="Diem Zangerl, Anja" uniqKey="Diem Zangerl A" first="Anja" last="Diem-Zangerl">Anja Diem-Zangerl</name></noRegion><name sortKey="Poewe, Werner" sort="Poewe, Werner" uniqKey="Poewe W" first="Werner" last="Poewe">Werner Poewe</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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