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Mortality from Parkinson’s disease in China: Findings from a five-year follow up study in Shanghai

  • Gang Wang (a1), Xin-Jian Li (a2), Yi-Song Hu (a3), Qi Cheng (a1), Chun-Fang Wang (a2), Qin Xiao (a1), Jun Liu (a1), Jian-Fang Ma (a1), Hai-Yan Zhou (a1), Jing Pan (a1), Yu-Yan Tan (a1), Ying Wang (a1) and Sheng-Di Chen (a1)...

Abstract

Introduction: The mortality of Parkinson’s disease (PD) and its associated risk factors among clinically definite PD patients in China has been rarely investigated. Our study aimed to identify the mortality rates and predictors of death in PD patients in China. Methods: 157 consecutive, clinically definite PD patients from the urban area of Shanghai were recruited from a central hospital based movement disorder clinic in 2006. All patients were regularly followed up at the clinic until December 31, 2011, or death. Mortality and associations with baseline demographics, health and medical factors were then determined within the cohort. Results: After 5 years, 11(7%) patients had died. The standardised mortality ratio was 0.62 (95% CI 0.32 to 1.07, P=0.104). The main causes of death were pneumonia (54.5%, 6/11) and digestive disorders (18.2%, 2/11), respectively. Age at onset, independent living, the mini mental state examination score, the Parkinson’s disease sleep scale score and the Epworth sleepiness scale score at baseline were statistically significantly different between the survival group and the deceased group (P<0.05). Across all participants, risk factors for death included low mini mental state examination score, and high Epworth sleepiness scale score according to a binary variable logistic regression analysis. Conclusions: This study confirms the similar survival of patients with PD to the control population up to a follow-up of 5 years. Interventions tailored to potential risk factors associated with death may offer further benefits.

Mortalité due à la maladie de Parkinson en Chine : observations tirées d’une étude de suivi à Shanghai. Introduction : En Chine, la mortalité due à la maladie de Parkinson (MP) et les facteurs qui y sont associés, chez les patients atteints de la MP dont le diagnostic clinique est certain, ont rarement été étudiés. Notre étude visait à identifier les taux de mortalité et les variables explicatives de la mortalité chez des patients atteints de la MP en Chine. Méthode : Cent cinquante-sept patients consécutifs atteints de la MP, dont le diagnostic était certain au point de vue clinique et résidant dans la zone urbaine de Shanghai, ont été recrutés dans une clinique des troubles du mouvement d’un hôpital central de la ville en 2006. Tous les patients ont été suivis régulièrement à la clinique jusqu’au 31 décembre 2011 ou jusqu’à leur décès. Les associations entre la mortalité et les caractéristiques démographiques au début du suivi, les facteurs de santé et les facteurs médicaux notés au cours du suivi de la cohorte ont été analysées. Résultats : Après 5 ans, 11 patients (7%) étaient décédés. Le ratio normalisé de mortalité était de 0,62 (95% IC de 0,32 à 1,07 ; p = 0,104). Les principales causes de décès étaient la pneumonie (54,5%, 6/11) et les maladies digestives (18,2%, 2/11). L’âge de début, l’autonomie, le score au mini-examen de l’état mental, le score du sommeil de la maladie de Parkinson et le score initial à l’échelle de somnolence diurne d’Epworth étaient significativement différents au point de vue statistique entre le groupe de patients qui étaient toujours vivants par rapport au groupe de patients décédés (p < 0,05). Parmi tous les participants, les facteurs de risque de décès incluaient un score bas au mini-examen de l’état mental et un score élevé à l’échelle de somnolence diurne d’EPworth, selon une analyse de régression logistique binaire. Conclusions : Cette étude confirme que la survie des patients atteints de la MP est similaire à celle d’une population témoin au cours d’un suivi de 5 ans. Des interventions ciblant les facteurs de risque potentiels associés au décès pourraient offrir des bénéfices additionnels à ces patients.

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Copyright

Corresponding author

Correspondence to: Dr Sheng-Di Chen, Department of Neurology & Institute of Neurology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China. E-mail: chen_sd@medmail.com.cn; or, Dr Ying Wang, Department of Neurology & Institute of Neurology, Rui Jin Hospital affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200025 China. E-mail: wangying@ medmail.com.cn

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