Objective: The aim was to carry out a long-term follow-up of a cohort of patients in late stage Parkinson’s disease (PD) with focus on mortality rate, cause of death and factors associated with mortality.

Background: We followed a Swedish cohort of 107 patients in late stage PD during the past decade, which provided the possibility to investigate factors related to mortality.

Method: Late stage PD was defined: Hoehn and Yahr IV-V in the “on” state and/or ≤ 50% independency on the Schwab & England ADL Scale. Non-motor symptoms (NMS) were assessed with the NMS Scale. Cognition was assessed with the Mini-Mental State Examination (MMSE).

Results: Among the participants, 62 (58%) were male, median age 78 years and disease duration 15 years, 74% of them in HY IV. Age at onset was median 63 years and at death 81 years. At baseline assessment, 64 (60%) of the participants lived at home, the rest in residential care. Three years after baseline assessment, 52 (49%) of the participants were alive. Five years after baseline assessment, 30 (28%) were alive and seven years after baseline assessment 14 (13%). At final follow-up 7-9 years after baseline assessment, 8 participants of the cohort were alive. The main causes of death recorded were aspiration pneumonia (34%), sepsis (17%), unspecified pneumonia (11%), ileus (6%) and Covid-19 (6%). Other main causes of death: iliopsoas abscess, zoster encephalitis, intracerebral infarction, intracerebral hemorrhage, aortic dissection, cardiac arrest, pulmonary embolism with acute cor pulmonale and influenza (seasonal). In simple logistic regression analyses, baseline variables that were significantly associated with (increased) mortality: worse ADL independency (P = 0.007), worse motor function (UPDRS III total score) (P = 0.007), higher age (P = 0.031) and worse cognition (MMSE total score) (P = 0.044).

Conclusion: In a cohort of 107 patients in late stage PD, at 3-year follow up 52 (49%) were alive, at 5-year 30 (28%) and at 7-year 14 (13%). At final follow-up 7-9 years after baseline assessment, 8 participants were alive. The most common main causes of death were aspiration pneumonia (34%), sepsis (17%) and unspecified pneumonia (11%). Simple logistic regression analyses identified worse ADL independency, worse motor function, higher age and worse cognition as significantly associated with (increased) mortality.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/mortality-rate-cause-of-death-and-factors-associated-with-mortality-in-late-stage-parkinsons-disease/