title: Survival in Parkinson's disease. Relation with motor and non-motor features.
abstract: BACKGROUND
  Survival in patients with Parkinson's disease is reduced as compared to the general population. We aimed to identify motor and non-motor features that predict mortality in Parkinson's disease.
  
  
  METHODS
  A broad range of motor and non-motor features were assessed in a hospital-based cohort of 414 patients with Parkinson's disease, who underwent five annual follow-up examinations including vital status assessment. Multivariable Cox's proportional hazards regression analysis was used to evaluate the association between baseline characteristics and mortality risk. Stepwise regression with backward elimination was carried out to determine the best model to predict mortality in Parkinson's disease.
  
  
  RESULTS
  After a mean follow-up period of 4.3 years, 49 (11.8%) patients had died. In the stepwise regression model, predictors of mortality in Parkinson's disease were higher age, male sex, cognitive impairment, higher postural instability gait disorder score, and the presence of psychotic symptoms.
  
  
  CONCLUSIONS
  Higher age, male sex, cognitive impairment, higher postural instability gait disorder score, and the presence of psychotic symptoms are independent predictors of decreased survival in Parkinson's disease. Mortality in Parkinson's disease thus seems to be affected mainly by non-dopaminergic and non-motor features.
authors.affiliation: Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands; Department of Neurology, Slotervaart Hospital, P.O. Box 90440, 1006 BK Amsterdam, The Netherlands. Electronic address: l.delau@erasmusmc.nl.
authors.forename: Lonneke M L
authors.initials: LM
authors.lastname: de Lau
authors.affiliation: Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Dagmar
authors.initials: D
authors.lastname: Verbaan
authors.affiliation: Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Johan
authors.initials: J
authors.lastname: Marinus
authors.affiliation: Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands.
authors.forename: Jacobus J
authors.initials: JJ
authors.lastname: van Hilten
mesh_terms: D000368:Aged; D003072:Cognition Disorders / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000401:mortality*; D011237:Predictive Value of Tests; D016016:Proportional Hazards Models; D011618:Psychotic Disorders / Q000209:etiology*; D012044:Regression Analysis
keywords: Mortality; Parkinson's disease; Prognosis; Survival