Dementia detracts from PD patients’ life expectancy

By Eleanor McDermid, Senior medwireNews Reporter

Patients with Parkinson’s disease (PD) have an increased risk for mortality, especially if they have dementia, a meta-analysis confirms.

Researchers Yu Fan (Jiangsu University, China) and team analyzed data from eight prospective, observational studies with 72,833 participants, including 1549 patients with PD, and follow-up durations ranging from 2.5 to 13.5 years. They found that, overall, patients with PD had a 2.22-fold increased mortality risk versus those without.

The risk varied with age, being a significant 2.40-fold increased in patients aged 65 years or older, whereas younger patients (assessed in two studies) were not at increased risk.

“A frail older patient has much lower tolerance to the severity of PD than a younger patient, which may result in a greater mortality rate in the older population,” say Fan et al in Acta Neurologica Scandinavica.

There was a trend toward greater mortality in patients younger than 65 years, they note, but this was not statistically significant and the unclear result could simply reflect the small number of patients in this age group.

The impact of PD on mortality tended to be higher in studies with shorter follow-up (≤5 years), in cohort than in case–control studies, and in studies that assessed patients with prevalent rather than incident PD. However, the significant impact of PD remained irrespective of study design.

Two studies assessed the impact of comorbid dementia. Patients with PD and dementia had a particularly large increase in mortality risk, at 3.78 times that of people without PD, whereas PD patients with no dementia had a smaller 2.63-fold increase.

“Given the slow progressive nature of PD and increased mortality with disease duration, knowledge on the mortality predictors among patients with PD is important,” say the researchers.

They add: “Earlier interventions in treating co-morbidities associated with increased mortality such as dementia or depression can help to improve the prognosis/survival of patients.”

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