The estimated life expectancy in a community cohort of Parkinson's disease patients with and without dementia, compared to the United Kingdom population.
Résumé
Objective: To compare survival, life expectancies (LE), and the anticipated age at the time of death (AAD), in a community-based cohort of Parkinson's disease (PD) patients with and without significant cognitive impairment, with an age sex matched population of England and Wales. Methods: The age and sex specific standardised mortality ratios (SMR) were calculated and stratified by dementia status. The LE and AAD estimations were calculated from the SMR's of the 2003 United Kingdom population, using a modified Gompertz function. Results: In total, 166 PD patients participated in the investigation, of which 91 died by the four-year follow-up. The overall SMR was 2.09 (95% CI 1.68, 2.57). Demented patients had significantly higher SMR's than non-demented patients (SMR3.10, 95% CI 2.39-3.96 vs. SMR 1.15, 95% CI 0.75 – 1.69 p< 0.001. In our cohort, the LE in younger onset demented patients (55-74 years) was much lower than in non-demented patients (7.5; SD 3 vs. 12.4; SD 7). Likewise, the estimated AAD in younger onset patients with dementia was also much lower (demented 72.4; SD 4 vs. not demented 77.8; SD 7). In older onset patients with dementia (< 75 years), the differences in LE (demented 2.1; SD 1 vs. not demented 4.7; SD 4), and AAD were less apparent (demented 89.5; SD 6 vs. not demented 92.2; SD 6). Conclusion: The survival, LE and AAD in patients with PD is much lower compared with the general population, apart from those patients who do not develop dementia, who appear to have near normal population mortality rates. However, dementia and younger onset of PD appear to be important determinants of survival, LE and AAD.
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