People with parkinsonism die on average sooner than others

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People with parkinsonism die on average sooner than others Patients with synucleinopathies died about two years earlier than people without

Louise Prime

Tuesday, 16 May 2017

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Patients who have synucleinopathies die on average two years earlier than people without one of this group of conditions, according to new research.
A population-based US study*, published in JAMA Neurology, showed that the risk of death during follow-up was highest in people with multiple system atrophy with parkinsonism. Risk was also raised in patients with dementia with Lewy bodies or Parkinson disease with dementia.
Mayo Clinic researchers examined data for all residents of Olmsted County, Minnesota. For the period 1991 to 2010 they found 461 patients with synucleinopathies — including 309 with Parkinson disease, 81 with dementia with Lewy bodies, 55 with Parkinson disease dementia and 16 with multiple system atrophy with parkinsonism. They defined Parkinsonism as the presence of at least two of four cardinal signs: rest tremor, bradykinesia, rigidity and impaired postural reflexes. They then identified 452 patients without synucleinopathies, whom they used for comparison.
The researchers reported that more than two-thirds (316 (68.6%)) of the 461 patients with synucleinopathies died during follow-up, compared with fewer than half (220 (48.7%)) of the 452 "control" participants.
The researchers found that overall, patients with synucleinopathies died about two years earlier than people in the comparison group who did not have them. They calculated from their results that the highest risk of death occurred among patients with multiple system atrophy with parkinsonism (hazard ratio (HR) 10.51), followed by patients with dementia with Lewy bodies (HR 3.94), Parkinson disease with dementia (HR 3.86) and Parkinson disease (HR 1.75).
The study authors noted limitations to their study. These included difficulty in assessing the precise chronology of symptoms, time of onset of clinical features, severity of parkinsonian symptoms and treatment history from an historical review of medical records. Nevertheless, they concluded: "Individuals with multiple system atrophy with parkinsonism, dementia with Lewy bodies, and Parkinson disease dementia have increased mortality compared with the general population. The mortality among persons with Parkinson disease is only moderately increased compared with the general population."

* Savica R, Grossardt BR, Bower JH, et al. Survival and causes of death among people with clinically diagnosed synucleinopathies with parkinsonism: a population-based study. JAMA Neurol. Published online May 15, 2017. doi:10.1001/jamaneurol.2017.0603.Type 2 Diabetes Treatment
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