Survival in Parkinson disease: thirteen-year follow-up of the DATATOP cohort.
OBJECTIVE
To investigate predictors of survival in Parkinson disease (PD).


METHODS
Vital status was determined in 800 subjects enrolled in a clinical trial of deprenyl (selegiline) and tocopherol 13 years earlier.


RESULTS
Two hundred ninety-six deaths were recorded. There was no difference in the standardized mortality ratios across gender or age group. In univariate analyses, PD-specific variables associated with mortality were increased symmetry of parkinsonism, gait dysfunction as an initial symptom, severity of parkinsonism, and rate of worsening of parkinsonism prior to study enrollment. Cumulative exposure to deprenyl was not associated with mortality. In multivariable analysis, severity of parkinsonism and rate of worsening of parkinsonism remained associated with mortality. A poorer response to levodopa was associated with increased mortality independent of disease severity or dosage of levodopa. Results were unchanged when the analysis was restricted to 747 subjects maintaining a most likely diagnosis of PD throughout 6 years of active follow-up.


CONCLUSIONS
Parkinson disease did not affect survival differently across gender or age groups in this selected group of otherwise healthy clinical trial participants. Severity and rate of worsening of parkinsonism and response to levodopa are strongly related to survival.
Marras
C
C
Division of Neurology, Toronto Western Hospital, University Health Network, University of Toronto, Ontario, Canada M5T 2S8. connie.marras@utoronto.ca
McDermott
M P
MP
Rochon
P A
PA
Tanner
C M
CM
Naglie
G
G
Rudolph
A
A
Lang
A E
AE
D015331:Cohort Studies; D004311:Double-Blind Method; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007980:Levodopa / Q000378:metabolism / Q000627:therapeutic use; D016013:Likelihood Functions; D008297:Male; D008875:Middle Aged; D015337:Multicenter Studies as Topic; D015999:Multivariate Analysis; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism / Q000401:mortality*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D016032:Randomized Controlled Trials as Topic; D012642:Selegiline / Q000627:therapeutic use; D016019:Survival Analysis; D013995:Time; D024505:Tocopherols / Q000627:therapeutic use
D012642:Selegiline; D007980:Levodopa; D024505:Tocopherols