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

Background: Standardized mortality ratio (SMR) is the most frequently used index in Parkinson's disease (PD) survival survey. However, there is little SMR data in PD from China. Objective: To examine the outcome, including overall and cause-specific mortality, of PD patients subsequent to 10 years of surveillance in Shanghai, China. This is an extension study of our previous investigation on mortality. Methods: One hundred fifty-seven PD patients recruited from the movement disorder clinic of Rui Jin Hospital in 2006 were followed up until December 31, 2016 or death, representing a follow-up period of up to 10 years. Overall and cause-specific standardized mortality ratios (SMR) were calculated, and predictors for survival at disease onset were estimated. Results: Thirty one patients had died by December 31, 2016, and the SMR at 10 years of follow-up was 0.87 (0.59-1.25). The primary direct cause of death was respiratory disease (SMR = 3.52, 95% CI 1.98-5.78). Employing Cox's proportional hazard modeling, postural instability gait disorder (PIGD) type and older age at onset predicted poor survival in this cohort. Conclusions: This finding confirms the similar survival of patients with PD to the control population in the post-delevodopa era. PIGD type and older age at onset had a negative impact on survival.