Mortality Trends in Parkinson’s Disease: Analysis of Top Comorbid Causes of Death Using CDC WONDER, 1999-2020
Ahmed Abdelmageed1, Samer hamed Mohamed Hamed Amer Salama2
1Faculty of Medicine, Mansoura University, Mansoura, Egypt, 2Neurology Department, Faculty of Medicine, Mansoura University, Mansoura, Egypt
Objective:

The aim of this study was to know the top causes of deaths among PD patients and to analyze their long-term patterns of mortality in the United States from 1999 to 2020.


Background:
Parkinson's disease (PD) is a progressive disorder of the nervous system that significantly affects rates of morbidity and mortality. Analysis of temporal associations of the top causes of fatality among patients with PD is valuable in informing prevention and support care protocols.
Design/Methods:

Age-adjusted mortality rates and standard errors of PD (ICD-10 code G20) were extracted from the CDC WONDER database from 1999 to 2020. The top five causes of death in PD were identified to be: atherosclerotic heart disease, Alzheimer's disease, acute myocardial infarction, stroke and pneumonia. Long-term trends over the years were identified by Joinpoint regression software (version 5.4) through determination of joinpoints by permutation test (4499 permutations) at an alpha of p < 0.05. The annual percentage change (APC) and average annual percentage change (AAPC) were computed.

Results:

Stroke (AAPC = -4.94%, 95% CI -5.26 to -4.61), pneumonia (AAPC = -7.15%, 95% CI -8.51 to -5.78), acute myocardial infarction (AAPC = -5.75%, 95% CI -6.96 to -4.51)  and atherosclerotic heart disease (AAPC = -3.73%, 95% CI -4.33 to -3.13) showed significant long-term reductions. Alzheimer’s disease showed variable patterns, characterized by an initial rise (1999-2005, APC = +5.19%) followed by a decrease (2005-2014, APC = -3.47%) and subsequent stabilization, resulting in a nonsignificant overall trend (AAPC = -0.05%, 95% CI -0.87 to 0.78).

Conclusions:
During the last 20 years, death rates from cardiovascular and infectious causes in PD patients significantly decreased. Alzheimer's disease mortality displayed a complicated course, pointing to the role of combined neurodegenerative disease care. These results indicate the value of specific preventive measures to reduce death rates in PD populations.
10.1212/WNL.0000000000215283
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