Overlap of Parkinson's Disease and Respiratory Failure in Older Adults: Epidemiologic Insights from CDC-WONDER Database (1999-2020)
Amna Amir Jalal1, Maryam Saghir1, Kashmala Rahl1, Eshal Saghir2, Nida Shohaib1, Muhammad Affan1, Mahtab zafar3, Nara Michaelson4
1Jinnah Sindh Medical University, 2Dow University of Health Sciences, 3Rahbar Medical and Dental College, 4Beth Israel Deaconess Medical Center
Objective:
To assess mortality trends due to the overlap of PD and respiratory failure in older U.S. adults from 1999 to 2020, highlighting the disparities across demographics and regions.
Background:
Parkinson’s disease (PD) is the second leading neurodegenerative disorder. Beyond just motor dysfunction, PD contributes to respiratory impairment through muscle weakness, rigidity, and airway obstruction. Respiratory failure is recognized as a significant cause of mortality in advanced PD.
Design/Methods:
We analyzed PD (ICD-10 code: G20) and respiratory failure (ICD-10 code: J96) mortality in the elderly, using the CDC-WONDER database from 1999 to 2020. Age-Adjusted Mortality Rates (AAMRs) per 100,000 were calculated and categorized by demographics and region. Joinpoint regression was used to estimate Annual Percent Change (APC) and Average Annual Percent Change (AAPC).
Results:
From 1999 to 2020, a total of 59,168 PD-related respiratory failure deaths were recorded among elderly aged ≥65 years. The AAMR observed a significantly marked incline from 5.5 to 11.3 (AAPC: 7.4; 95% CI: 6.5 to 8.4, p<0.01). Men had higher overall AAMR (10.5) than women (3.9). Racially, Non-Hispanic (NH) White population had the highest overall AAMR (6.8), and NH Black (3.5) had the lowest. Regionally, the highest overall AAMR was recorded by the West (8.3), followed by the Northeast (6.9), the South (5.9) and the Midwest (5.3). Non-metropolitan areas had lower AAMR than metropolitan areas (5.8 vs 6.6). States that fell in the top 90th percentile were Nebraska, California, Connecticut, and Mississippi.
Conclusions:
This study highlights a marked rise in PD–related respiratory failure deaths in the U.S. from 1999 to 2020, with notable disparities. Mortality was higher in males, NH Whites, and the West. Rural areas experienced a pronounced surge, reflecting limited access to special care. These findings underscore widening inequities, the need for targeted policies, and equitable resource allocation in high-risk and vulnerable groups.
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