title: Mortality in Iranian Patients with Parkinson's Disease: Cumulative Impact of Cardiovascular Comorbidities as One Major Risk Factor.
abstract: Mortality rate, life expectancy, survival, and the impact of comorbidities on them in people with Parkinson's disease (PD) need to be assessed in settings with different sociodemographic backgrounds. We investigated mortality features in Iranian PD patients focusing on the role of cardiovascular multimorbidity on their survival. Data on mortality and comorbidity profile was gathered in a cohort of 190 individuals with idiopathic PD referred to a Movement Disorders Clinic. Standardized mortality ratio (SMR) compared to the Tehran general population was 3.44 and the life expectancy at birth was 67.4 (95% CI: 59.1-75.8) yr. Patients with at least one cardiovascular comorbidity had a shorter survival time after PD onset (14.0 versus 29.2 yr, p = 0.012). The hazard ratio for death increased 2.8 times (95% CI: 1.5-5.2, p = 0.002) with one additional cardiovascular comorbidity. Among all comorbid conditions, stroke showed the strongest independent effect on mortality in PD patients [HR = 13.1 (95% CI: 2.4-71.7), p = 0.003]. Conclusively, life expectancy was slightly lower in Iranian PD patients compared to the general population, while the SMR was high. Cardiometabolic multimorbidity substantially decreased survival in people with PD. Our study highlights the need for assessment, prevention, and treatment of cardiovascular morbidities in parkinsonian patients, given their effect on survival.
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, 14186 Stockholm, Sweden ; Firoozgar Clinical Research Development Center (FCRDC), Firoozgar Hospital, Iran University of Medical Sciences, Tehran 15937-48711, Iran.
authors.forename: Seyed-Mohammad
authors.initials: SM
authors.lastname: Fereshtehnejad
authors.affiliation: Students Scientific Research Committee (SSRC), Faculty of Medicine, Tehran University of Medical Sciences, Tehran 14176-14411, Iran.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Shafieesabet
authors.affiliation: Medical Student Research Committee (MSRC), Faculty of Medicine, Iran University of Medical Sciences, Tehran 14496-14535, Iran.
authors.forename: Mahdiyeh
authors.initials: M
authors.lastname: Shafieesabet
authors.affiliation: Movement Disorders Clinic, Department of Neurology, Faculty of Medicine, Iran University of Medical Sciences, Tehran 14496-14535, Iran.
authors.forename: Gholam Ali
authors.initials: GA
authors.lastname: Shahidi
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, 14186 Stockholm, Sweden ; Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran 19857-13834, Iran.
authors.forename: Ahmad
authors.initials: A
authors.lastname: Delbari
authors.affiliation: Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society (NVS), Karolinska Institutet, 14186 Stockholm, Sweden ; Department of Geriatric Medicine, Karolinska University Hospital, 14186 Stockholm, Sweden.
authors.forename: Johan
authors.initials: J
authors.lastname: Lökk