Mariana Moscovich1, Gabriela Boschetti2, Adriana Moro1, Helio A G Teive3, Anhar Hassan4, Renato P Munhoz5. 1. Movement Disorders Unit, Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil; Parkinson Association of Paraná, Curitiba, PR, Brazil. 2. Department of Neurology, Hospital Universitário Cajuru, Pontifícia Universidade Católica do Paraná, Curitiba, PR, Brazil. 3. Movement Disorders Unit, Neurology Service, Hospital de Clínicas, Federal University of Paraná, Curitiba, PR, Brazil. 4. Department of Neurology, Mayo Clinic, Rochester, MN, USA. 5. Movement Disorders Centre, Toronto Western Hospital, University of Toronto, Toronto, ON, Canada. Electronic address: Renato.munhoz@uhn.ca.
Abstract
INTRODUCTION: Assessment of variables related to mortality in Parkinson disease (PD) and other parkinsonian syndromes relies, among other sources, on accurate death certificate (DC) documentation. We assessed the documentation of the degenerative disorder on DCs and evaluated comorbidities and causes of death among parkinsonian patients. METHODS: Demographic and clinical data were systematically and prospectively collected on deceased patients followed at a tertiary movement disorder clinic. DCs data included the documentation of parkinsonism, causes, and place of death. RESULTS: Among 138 cases, 84 (60.9%) male, mean age 77.9 years, mean age of onset 66.7, and mean disease duration 10.9 years. Clinical diagnoses included PD (73.9%), progressive supranuclear palsy (10.9%), multiple system atrophy (7.2%), Lewy body dementia (7.2%) and corticobasal degeneration (0.7%). Psychosis occurred in 60.1% cases, dementia in 48.5%. Most PD patients died due to heterogeneous causes before reaching advanced stages. Non-PD parkinsonian patients died earlier due to causes linked to the advanced neurodegenerative process. PD was documented in 38.4% of DCs with different forms of inconsistencies. That improved, but remained significant when it was signed by a specialist. CONCLUSIONS: More than half of PD cases died while still ambulatory and independent, after a longer disease course and due to causes commonly seen in that age group. Deaths among advanced PD patients occurred due to causes similar to what we found in non-PD cases. These findings can be useful for clinical, prognostic and counseling purposes. Underlying parkinsonian disorders are poorly documented in DCs, undermining its' use as sources of data collection.
INTRODUCTION: Assessment of variables related to mortality in Parkinson disease (PD) and other parkinsonian syndromes relies, among other sources, on accurate death certificate (DC) documentation. We assessed the documentation of the degenerative disorder on DCs and evaluated comorbidities and causes of death among parkinsonianpatients. METHODS: Demographic and clinical data were systematically and prospectively collected on deceased patients followed at a tertiary movement disorder clinic. DCs data included the documentation of parkinsonism, causes, and place of death. RESULTS: Among 138 cases, 84 (60.9%) male, mean age 77.9 years, mean age of onset 66.7, and mean disease duration 10.9 years. Clinical diagnoses included PD (73.9%), progressive supranuclear palsy (10.9%), multiple system atrophy (7.2%), Lewy body dementia (7.2%) and corticobasal degeneration (0.7%). Psychosis occurred in 60.1% cases, dementia in 48.5%. Most PDpatients died due to heterogeneous causes before reaching advanced stages. Non-PD parkinsonianpatients died earlier due to causes linked to the advanced neurodegenerative process. PD was documented in 38.4% of DCs with different forms of inconsistencies. That improved, but remained significant when it was signed by a specialist. CONCLUSIONS: More than half of PD cases died while still ambulatory and independent, after a longer disease course and due to causes commonly seen in that age group. Deaths among advanced PDpatients occurred due to causes similar to what we found in non-PD cases. These findings can be useful for clinical, prognostic and counseling purposes. Underlying parkinsonian disorders are poorly documented in DCs, undermining its' use as sources of data collection.
Authors: Fulvio A Scorza; Antonio Carlos G de Almeida; Carla A Scorza; Josef Finsterer Journal: Clinics (Sao Paulo) Date: 2021-09-03 Impact factor: 2.365
Authors: Paulo Bugalho; Filipa Ladeira; Raquel Barbosa; João Pedro Marto; Claudia Borbinha; Manuel Salavisa; Laurete da Conceição; Marlene Saraiva; Marco Fernandes; Bruna Meira Journal: J Neural Transm (Vienna) Date: 2019-08-05 Impact factor: 3.575
Authors: Mariana Nejm; Marcia Guimarães-Marques; Carla A Scorza; Daniella B Victorino; Josef Finsterer; Ana C Fiorini; Fulvio A Scorza Journal: Public Health Pract (Oxf) Date: 2020-05-05