Predicting Mortality in Parkinson's Disease: The Role of Motor Complications

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Progression of motor complications may contribute to mortality in Parkinson’s disease.
Progression of motor complications may contribute to mortality in Parkinson’s disease.
The following article is part of live conference coverage from the 2017 International Congress of Parkinson's Disease and Movement Disorders (MDS) in Vancouver, British Columbia, Canada. Neurology Advisor's staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from MDS 2017.

VANCOUVER — For patients with Parkinson's disease, motor complications and other complications of therapy predicted mortality at 4 years, whereas the burden of nonmotor symptoms did not, according to new research.

The findings were presented at the 2017 International Congress of Parkinson's Disease and Movement Disorders.

The longitudinal study included 147 nondemented patients with Parkinson's disease (57.1% men; age, 70.9 ± 8.6 years). The researchers used the Unified Parkinson's Disease Rating Scale part-IV (UPDRS-IV) to evaluate motor complications and other therapeutic complications, and the Non-Motor Symptoms Scale (NMSS) total score to evaluate the burden of non-motor symptoms.

During follow-up (48 months), 15.1% of patients died. Results indicated that patients who died had a higher baseline UPDRS-IV score (3.5 ± 3.1 vs. 2.4 ± 2.4; P =.049) and NMSS total score (96.9 ± 58.6 vs. 61.9 ± 51; P =.004) than those who survived. The unadjusted hazard ratio (HR) for death was 1.171 (95% CI: 1.012-1.357; P =.035) for UPDRS-IV and 1.008 (95% CI: 1.002-1.013; P =.006) for NMSS total score.

After adjustment, independent predictors of death included UPDRS-IV (HR, 1.224 for 1-unit increase; 95% CI: 1.002-1.494; P =.047); age (HR, 1.231 for year increase; 95% CI: 1.104-1.374; P <.0001); and comorbidity status (HR, 1.429 for 1-unit increase in Charlson Index score; 95% CI: 1.023-1.994; P =.036). However, NMSS total score was not a predictor of mortality (HR, 1.005 for 1-unit increase; 95% CI: 0.996-1.014; P =.263).

“Motor complications and others of therapy (UPDRS-IV), but not non-motor symptoms burden (NMSS total score) predict short-term mortality in non-demented [Parkinson's disease] patients,” the researchers concluded.


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Reference

García DS, Castro ES, Ruíz IE, et al. Motor complications and others of therapy but not non-motor symptoms burden predict short-term mortality in non-demented Parkinson‘s disease patients. Presented at: 2017 International Congress of Parkinson's Disease and Movement Disorders. June 4-8, 2017; Vancouver, BC, Canada. Abstract 59.

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