Objective: To determine the effect of dysphagia and hospital admissions on mortality in late stage Parkinson’s disease.

Background: Parkinson’s disease (PD) is a neurodegenerative condition associated with increased mortality. Previous research surrounding predictors of mortality has focused on newly diagnosed rather than late stage PD.

Method: A prospective study was undertaken with consenting later stage PD patients (Hoehn and Yahr stages III-V) known to the Northumbria Parkinson’s Service, who were interviewed at baseline and had deaths, hospital and care home admissions recorded for 2 years. Dysphagia was assessed with a binary question and using question 2.3 of the Unified Parkinson’s Disease Rating Scale.

Results: Of the 162 patients, 36 (22.2%) died during follow-up and 18 patients (11.1%) entered a care home, including 10 of the 36 that died. 72.7% (8/11) of patients with a score of 3 (choking episode in the last week) on UPDRS 2.3 died compared to 14.9% (7/59) of those with a score of 0 (No swallowing problems) (p =0.0004). Similarly, when assessed using the binary question, those with dysphagia had a greater mortality rate (32.6% (15/46) vs 17.4% (20/115), p = 0.034, with one patient where the question was not applicable due to PEG feeding). Of those with no hospital admissions, 14.9% (14/94) died, compared to 30.0% (3/10) of patients with 2 admissions and 41.2% (7/17) of those with 3 or more admissions (p = 0.006).

Conclusion: There was a significant increase in mortality in patients with dysphagia as measured using both UPDRS 2.3 and a yes/no question. Patients with hospital admissions showed increased mortality rates, so may warrant closer monitoring. The data appears to show increasing mortality with an increasing number of hospital admissions, though the number of patients with a large amount of admissions was relatively low.

« Back to 2019 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/factors-affecting-mortality-in-late-stage-parkinsons-disease/