{"title":"All-Cause and Cause-Specific Mortality in Parkinson's Disease: A Meta-Analysis.","authors":"Young Ho Lee, Gwan Gyu Song","doi":"10.1159/000546136","DOIUrl":null,"url":null,"abstract":"<p><strong>Objectives: </strong>This study aimed to assess the overall and cause-specific standardized mortality ratios (SMRs) in patients diagnosed with Parkinson's disease (PD).</p><p><strong>Methods: </strong>A systematic review was conducted, focusing on studies that evaluated SMRs for all causes and specific causes in PD patients compared to the general population. Searches were performed extensively in Medline, Embase, and Cochrane databases to compile relevant literature. A meta-analysis was subsequently conducted to evaluate all-cause, sex-specific, region-specific, and cause-specific SMRs in individuals with PD.</p><p><strong>Results: </strong>Twenty-one studies including 26,114 PD patients and 10,247 deaths from 12 European, 4 Asian, 3 Oceanian, 1 North American, and 1 Middle Eastern country met the inclusion criteria. The overall SMR analysis revealed that PD patients exhibited a 1.617-fold higher risk of all-cause mortality compared to the general population (SMR 1.617, 95% CI confidence interval [CI], 1.295-2.020, p < 0.001). Region-specific analysis showed significant SMR increases across all regions. Sex-specific analysis indicated elevated SMRs for both women (SMR 1.702, 95% CI 1.426-2.033, p < 0.001) and men (SMR 1.588, 95% CI 1.365-1.848, p < 0.001). PD onset before 60 years of age was associated with a higher, albeit not statistically significant, SMR compared to onset after 60 (SMR 1.991, 95% CI 1.313-3.021 vs. SMR 1.589, 95% CI 1.109-2.277). Cause-specific analyses revealed significantly increased SMRs for pneumonia (SMR 3.414, 95% CI 2.227-5.234, p < 0.001), cerebrovascular accidents (CVA) (SMR 1.484, 95% CI 1.048-2.102, p = 0.026), cardiovascular disease (SMR 1.449, 95% CI 1.156-1.816, p = 0.001), and suicide (SMR 2.049, 95% CI 1.383-3.035, p < 0.001), with no significant increase observed for cancer-related mortality.</p><p><strong>Conclusion: </strong>These findings highlight the increased mortality risk in PD patients, particularly due to causes such as pneumonia and CVA.</p>","PeriodicalId":54730,"journal":{"name":"Neuroepidemiology","volume":" ","pages":"1-25"},"PeriodicalIF":3.2000,"publicationDate":"2025-04-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Neuroepidemiology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1159/000546136","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CLINICAL NEUROLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Objectives: This study aimed to assess the overall and cause-specific standardized mortality ratios (SMRs) in patients diagnosed with Parkinson's disease (PD).
Methods: A systematic review was conducted, focusing on studies that evaluated SMRs for all causes and specific causes in PD patients compared to the general population. Searches were performed extensively in Medline, Embase, and Cochrane databases to compile relevant literature. A meta-analysis was subsequently conducted to evaluate all-cause, sex-specific, region-specific, and cause-specific SMRs in individuals with PD.
Results: Twenty-one studies including 26,114 PD patients and 10,247 deaths from 12 European, 4 Asian, 3 Oceanian, 1 North American, and 1 Middle Eastern country met the inclusion criteria. The overall SMR analysis revealed that PD patients exhibited a 1.617-fold higher risk of all-cause mortality compared to the general population (SMR 1.617, 95% CI confidence interval [CI], 1.295-2.020, p < 0.001). Region-specific analysis showed significant SMR increases across all regions. Sex-specific analysis indicated elevated SMRs for both women (SMR 1.702, 95% CI 1.426-2.033, p < 0.001) and men (SMR 1.588, 95% CI 1.365-1.848, p < 0.001). PD onset before 60 years of age was associated with a higher, albeit not statistically significant, SMR compared to onset after 60 (SMR 1.991, 95% CI 1.313-3.021 vs. SMR 1.589, 95% CI 1.109-2.277). Cause-specific analyses revealed significantly increased SMRs for pneumonia (SMR 3.414, 95% CI 2.227-5.234, p < 0.001), cerebrovascular accidents (CVA) (SMR 1.484, 95% CI 1.048-2.102, p = 0.026), cardiovascular disease (SMR 1.449, 95% CI 1.156-1.816, p = 0.001), and suicide (SMR 2.049, 95% CI 1.383-3.035, p < 0.001), with no significant increase observed for cancer-related mortality.
Conclusion: These findings highlight the increased mortality risk in PD patients, particularly due to causes such as pneumonia and CVA.
目的：本研究旨在评估帕金森病（PD）患者的总体和病因特异性标准化死亡率（SMRs）。方法：进行了系统回顾，重点研究了PD患者与一般人群比较的所有原因和特定原因的smr。在Medline， Embase和Cochrane数据库中进行了广泛的搜索，以汇编相关文献。随后进行了一项荟萃分析，以评估PD患者的全因、性别特异性、区域特异性和原因特异性smr。结果：来自12个欧洲、4个亚洲、3个大洋洲、1个北美和1个中东国家的21项研究，包括26114例PD患者和10247例死亡，符合纳入标准。总体SMR分析显示，PD患者的全因死亡率比一般人群高1.617倍（SMR为1.617,95% CI可信区间[CI]， 1.295-2.020, p < 0.001）。具体区域分析显示，所有区域的小生境均显著增加。性别特异性分析显示，女性（SMR为1.702,95% CI为1.426-2.033,p < 0.001）和男性（SMR为1.588,95% CI为1.365-1.848,p < 0.001）的SMR均升高。60岁前PD发病与60岁后发病的SMR相关，尽管没有统计学意义（SMR 1.991, 95% CI 1.313-3.021 vs. SMR 1.589, 95% CI 1.109-2.277）。原因特异性分析显示，肺炎（SMR 3.414, 95% CI 2.226 -5.234, p < 0.001）、脑血管意外（SMR 1.484, 95% CI 1.048-2.102, p = 0.026）、心血管疾病（SMR 1.449, 95% CI 1.156-1.816, p = 0.001）和自杀（SMR 2.049, 95% CI 1.383-3.035, p < 0.001）的SMR显著增加，而癌症相关死亡率未见显著增加。结论：这些发现强调了PD患者的死亡风险增加，特别是由于肺炎和CVA等原因。
期刊介绍：
''Neuroepidemiology'' is the only internationally recognised peer-reviewed periodical devoted to descriptive, analytical and experimental studies in the epidemiology of neurologic disease. The scope of the journal expands the boundaries of traditional clinical neurology by providing new insights regarding the etiology, determinants, distribution, management and prevention of diseases of the nervous system.
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