Cognitive impairment, dysphagia, postural instability gait difficulty associated with risk
Raymond Y. Lo, M.D., of the Parkinson's Institute and Clinical Center in Sunnyvale, Calif., and colleagues analyzed Kaiser Permanente Medical Care Program data on 573 subjects with Parkinson's disease that was newly diagnosed during 1994 and 1995. Subjects were followed for death until the end of 2005. During follow-up, the researchers note that 352 subjects died. Factors associated with a higher risk of all-cause mortality included severe cognitive impairment based on Mini-Mental State Examination scores, symmetry of motor signs, older age at diagnosis, dysphagia, and postural instability gait difficulty subtype (hazard ratios, 2.7, 2.0, 1.1, 1.4, and 1.8, respectively). "In this multiethnic incident Parkinson's disease cohort, we conclude that several motor and non-motor features in early Parkinson's disease can predict higher mortality risk, particularly older age at diagnosis, postural instability gait difficulty, cognitive impairment, and hallucinations. Our findings are in keeping with those of others, suggesting that these results are robust and generalizable. With effective clinical predictors, we can improve understanding of the disease process, refine risk stratification in designing clinical trials, and guide decision making in clinical practice," the authors conclude.
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