Objective: this study was carried out to analyze the average time taken for parkinson patients to progress from HY stage 5 to death, and investigate any variables that would be associated with this progression time.

Background: The clinical course of Parkinson disease (PD) varies from patient to patient. The Hoehn and Yahr (HY) scale has been used worldwide to estimate the severity of PD. Its transition time is a useful measure for PD progression. The transition time from one HY stage to the next has been studied previously. To complete the observation of the PD timeline, this study was carried out to analyze the average time taken for patients to progress from HY stage 5 to death, and investigate any variables that would be associated with this progression time.

Methods: Data was obtained from the Movement Disorders Database of National Neuroscience Institute which captures demographic information and disease characteristics. All study patients were linked to the Singapore National Registry of Disease Office to obtain on death information from January 1, 2002 to December 31, 2012. Patient profiles were reviewed. SPSS version 22 was used to analyse data.

Results: Within the study period, 2012 PD patients were identified in the database, 366 (18.2%) had died during the 11-year study period. Of these, 350 were died of natural causes who had available data for analysis. One hundred fifteen patients were at HY 5 when they died. Among the 115 patients, 56 were female and 98 patients were Chinese. The mean age at death was 77.79 ±8.78 while the mean duration of disease was 9.79 years±5.12. Mean UPDRS motor score at HY 5 was 47.39 ±17.44. The mean duration between HY 5 to death was 2.48 years ±2.20. Females (β 1.21, 95% CI: 0.426 to 1.994, p=0.003 ) and older patients (β 0.05, 95% CI: 0.004 to 0.096 p=0.032) lived significantly longer in simple linear regression and multiple linear regressions models.

Conclusions: A better knowledge of a PD patient’s life expectancy at HY stage 5 will enable patients and family members to better prepare for death, and enable physicians to better facilitate advanced care planning discussions.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/life-expectancy-for-parkinson-patients-at-hoehn-and-yahr-stage-5/