Department of Neurology, University Hospital 12 de Octubre, Madrid, Spain.
Mov Disord. 2011 Dec;26(14):2522-9. doi: 10.1002/mds.23921. Epub 2011 Sep 13.
Most studies of mortality in Parkinson's disease have been clinical studies, yielding results that are not representative of the general population. We assessed the risk of mortality from Parkinson's disease in the Neurological Disorders in Central Spain (NEDICES) study, a prospective population-based study in which Parkinson's disease patients who were not ascertained through medical practitioners were also included. The cohort consisted of 5262 elderly subjects (mean baseline age, 73.0 years), including 81 with Parkinson's disease at baseline (1994-1995). Thirteen-year mortality was assessed. Two thousand seven hundred and one of 5262 subjects (51.3%) died over a median follow-up of 12.0 years (range, 0.04-14.8 years), including 66 of 81 subjects (81.5%) with Parkinson's disease at baseline and 2635 of 5181 subjects (50.8%) without Parkinson's disease at baseline. In an unadjusted Cox model, the hazard ratio of mortality was increased in subjects with Parkinson's disease (hazard ratio, 2.29; 95% confidence interval, 1.80-2.93; P < .001) versus subjects without Parkinson's disease (reference group). In a Cox model that adjusted for a variety of demographic factors and comorbidities, the risk of mortality remained elevated in subjects with Parkinson's disease (hazard ratio, 1.75; 95% CI, 1.32-2.31, P < .001). In additional Cox models, Parkinson's disease patients with dementia had particularly high risks of mortality (adjusted hazard ratio, 2.62; 95% CI, 1.40-4.90; P < .001). In this prospective population-based study, Parkinson's disease was an independent predictor of mortality in the elderly. Parkinson's disease patients with dementia had particularly high risks of mortality.
大多数帕金森病死亡率的研究都是临床研究，其结果不能代表一般人群。我们评估了西班牙中部神经紊乱（NEDICES）研究中帕金森病死亡率的风险，这是一项前瞻性基于人群的研究，其中也包括了未经医生确诊的帕金森病患者。该队列由 5262 名老年受试者组成（平均基线年龄为 73.0 岁），其中 81 名受试者在基线时有帕金森病（1994-1995 年）。评估了 13 年的死亡率。在中位随访 12.0 年（范围为 0.04-14.8 年）期间，5262 名受试者中有 2711 名（51.3%）死亡，其中 81 名基线时有帕金森病的受试者中有 66 名（81.5%）死亡，5181 名基线时无帕金森病的受试者中有 2635 名（50.8%）死亡。在未调整的 Cox 模型中，帕金森病患者的死亡风险比（HR）高于无帕金森病的患者（HR，2.29；95%置信区间，1.80-2.93；P<0.001）。在调整了各种人口统计学因素和合并症的 Cox 模型中，帕金森病患者的死亡风险仍然较高（HR，1.75；95%CI，1.32-2.31，P<0.001）。在其他 Cox 模型中，有痴呆的帕金森病患者的死亡率风险特别高（调整后的 HR，2.62；95%CI，1.40-4.90；P<0.001）。在这项前瞻性基于人群的研究中，帕金森病是老年人死亡的独立预测因素。有痴呆的帕金森病患者的死亡率风险特别高。
