Objective: To longitudinally investigate the overall survival (OS) of a large cohort of Parkinson’s disease (PD) patients.

Background: While there is evidence of increasing incidence, prevalence and male-to-female ratio of PD [1], possible changes in the prognosis and mortality of PD patients are less well known. Survival in another neurodegenerative disease, Huntington’s disease, has increased. [2,3] Improvements in basic care have been postulated as a cause and this might also affect survival in PD. Furthermore, although pharmacotherapy has remained mostly unaltered, recent advances in device-aided therapies might have also affected survival in PD.

Method: We performed a 9-year (2006–2014) longitudinal investigation of newly diagnosed PD patients in southwestern Finland using individual digital health records that were followed until the end of follow-up (2016) or death. The cohort was divided into three groups based on the year of diagnosis. Demographic factors were compared between groups using ANOVA and Chi-Square tests. Kaplan-Meier analysis and log-rank statistics were used to analyze the OS from the time of diagnosis.

Results: A total of 1521 PD patients (Men (M): 824, Women (W): 697) were identified. The number of new diagnoses remained stable (M: 261-292 per three years, p=0.14, F: 216-256 per three years, p=0.14). Men were diagnosed at younger age than women (71.6 years, SD 10.5 vs. 74.1 years, SD 10.4; p<0.01) but the age difference and mean age at diagnosis remained stable (M: p=0.41, W: p=0.84). During the study period, 685 (45.0%) patients died (M: 388, W: 297). OS of male PD patients increased during the follow up (p=0.03), but no change was observed in women (p=0.42) [Table 1]. Results remained the same when patients with device-aided therapies were excluded.

Conclusion: The survival of Finnish men after PD diagnosis has improved over a period of nine years without a similar change in women. Since improvements in the treatment of advanced PD likely affect both sexes similarly, our results might stem from the fact that the general life expectancy in Finland has improved more in men than women in recent years. The increase in OS in male patients could thus reflect the epidemiological effect of competing causes of death. However, since gender differences in treatment cannot be ruled out further studies are needed on this subject.

References: 1. Kaasinen V, Vahlberg T, Suominen S. Increasing age-adjusted male-to-female incidence ratio of Parkinson’s disease. Mov Disord 2015; 30(2): 286-8. 2. Sánchez-Díaz G, Arias-Merino G, Villaverde-Hueso A, et al. Monitoring Huntington’s Disease Mortality across a 30-Year Period: Geographic and Temporal Patterns. Neuroepidemiology 2016; 47(3-4): 155-63. 3. Rodrigues FB, Abreu D, Damásio J, et al. Survival, Mortality, Causes and Places of Death in a European Huntington’s Disease Prospective Cohort. Mov Disord Clin Pract. 2017;4(5):737-42.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/gender-dependent-improvement-in-the-survival-of-parkinsons-disease-patients-in-finland/