Objective: To study comorbidities in Parkinson’s disease (PD) in the US.

Background: PD is a chronic multisystem progressive neurodegenerative disease. Understanding patient comorbidities is important in the management of PD. We examined common coexisting comorbidities in patients with PD in outpatient care using a nationally representative population.

Methods: We examined all outpatient and urgent care visits with diagnosis of PD (ICD-9 code 332.0) using CDC’s National Ambulatory Medical Care Survey (NAMCS, 2006–2012) and National Hospital Ambulatory Medical Care Survey (NHAMCS, 2006–2011). NAMCS is a national survey based on visits to office-based physicians, while NHAMCS surveys visits to the emergency and outpatient departments of hospitals. These surveys use nationally representative samples, using a multistage probability design, and provide objective information on all outpatient care in the US, regardless of insurance status. 

Comorbidity data was gathered from physician reports of 14 significant concurrent disease conditions: arthritis, asthma, cancer, cerebrovascular disease, chronic obstructive pulmonary disease, chronic renal failure, congestive heart failure, depression, diabetes, hyperlipidemia, hypertension, ischemic heart disease, obesity, and osteoporosis.

Results: During the study period, there were approximately 11.55 million visits in patients with PD in the US. A specified comorbidity was reported in 8.1 million visits (70.2%). Comorbidities were more common in older individuals (72.3% in ≥65 years vs 62.0% in <65 years) and men (73.0% vs 70.2% in women). The most commonly recorded comorbidity was hypertension (37.8%), followed by hyperlipidemia (21.2%), diabetes (19.1%), arthritis (16.82%), and cerebrovascular disease (8.61%). Depression was seen in 18.3% visits, and was significantly more common in men (18.9%) compared with women (17.5%, P<0.05), and in older individuals (≥65 years) compared with younger individuals (18.6% vs 16.8%, respectively, P<0.05).

Conclusions: Patients with PD have a high burden of comorbid conditions. Understanding the impact of these conditions on outcomes and the management of these disorders in people with and without PD would guide recommendations for clinical practice.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsons-disease-and-comorbidity-a-us-national-perspective/