Mortality Burden of Parkinson’s Disease versus Parkinson’s Disease with Aspiration Pneumonia Among Older Adults: A Retrospective Analysis from CDC-WONDER (1999-2023)
Muhammad Saim1, Waqas Ahmad1, Areeba Basaria2, Jamil Numan3, Abdul Eizad Asif4, Humna Shahid1, Faseeh Haider5, Atif Malik1, Talha Sajjad1, Anfal Hamza1, Arbaz Hassan1, Syed Inam6, Fahim Barmak7
1Sheikh Zayed Medical College/Hospital, 2Dow University of Health Sciences, 3Marshall University/ MUSOM, 4Shalamar Medical and Dental College, 5Allama Iqbal Medical College, 6Louisiana State University School of Medicine New Orleans Neurology, 7Marshall University
Objective:
This study compares Parkinson's disease with and without aspirational pneumonia to identify differences in outcomes, hospitalization trends, and mortality risk in the U.S. population.
Background:

Parkinson’s disease is a common neurodegenerative disorder frequently complicated by aspiration pneumonia due to dysphagia and impaired cough reflex. Aspiration pneumonia markedly increases morbidity, mortality, and healthcare burden in Parkinson’s disease. However, comparative analyses of mortality and hospitalization trends in these patients remain unexplored.

Design/Methods:

A retrospective analysis of the CDC WONDER database (1999–2023) was conducted to assess mortality trends of Parkinson’s disease with and without aspiration pneumonia among U.S. adults aged ≥55 years. Age-adjusted mortality rates per 100,000 population were calculated and stratified by sex, race/ethnicity, urbanization, and census region. Joinpoint regression (JPR) analysis estimated annual percent changes (APCs) with 95% confidence intervals, using p < 0.05 for significance.

Results:

From 1999 to 2023, Parkinson’s disease caused 514,459 deaths, including 33,002 with multiple causes, showing three joinpoints: gradual rise from 1999–2014 (2.26%; p = 0.008), sharp increase from 2014–2017 (8.03%; p = 0.006), and plateau from 2017–2023 (1.79%; p = 0.066). Female mortality declined until 2019, then rose (10.71%; p = 0.004), while male mortality fell (–2.06%; p < 0.001). Hispanic and Black populations showed rising mortality, contrasting with stability in White and Asian groups. Mortality was highest in Washington (6.1) and lowest in Mississippi (1.4). Aspiration pneumonia deaths rose until 2021 (4.32%; p < 0.001) before stabilizing, with persistent rural excess.

Conclusions:

Aspiration pneumonia remains the leading cause of death in Parkinson’s disease patients, with disparities across sex, race, and region. Early dysphagia screening and culturally tailored respiratory care can help reduce preventable deaths.

10.1212/WNL.0000000000216926
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.