[A study of attitudes toward illness and its effect on mortality in patients with Parkinson's disease].

The standardized mortality ratio (SMR), i.e. the ratio of observed to expected deaths, was investigated among 433 patients with Parkinson's disease (172 males and 261 females), who had been visited by public health nurses for a period of more than one year between 1978 and 1987 in Osaka Prefecture. The mean age of the patients was 58.7, and the average duration of the disease was 6.1 years at study entry. The follow-up period averaged 4.1 years during which sixty eight deaths were observed. The SMR of the patients was 2.54 relative to the general population of Osaka Prefecture. The SMR of those who were able to walk without assistance at study entry was 1.73, while that of patients with severe gait disturbance was 3.81. Patients were divided into three groups according to the extent of daily physical exercise performed to maintain their remaining function. Among patients who had been able to walk, those doing daily physical exercise showed the lowest SMR of 1.46. Among those with severe gait disturbance, the SMR of the exercising group was also the lowest at 1.72. These results indicate that daily physical exercise affects the mortality of Parkinsonian patients independently of the grade of disability. Participation in daily exercise was strongly influenced by the patient's will to battle his illness, and was significantly related to the presence of a spouse, economic situation of household, and the number of rooms in their dwelling.