Mortality from Parkinson's disease in China: Findings from a ten-year follow up study in Shanghai

Abstract Background Standardized mortality ratio (SMR) is the most frequently used index in Parkinson's disease (PD) survival survey. However, there is little SMR data in PD from China. Objective To examine the outcome, including overall and cause-specific mortality, of PD patients subsequent to 10 years of surveillance in Shanghai, China. This is an extension study of our previous investigation on mortality.
 Methods One hundred fifty-seven PD patients recruited from the movement disorder clinic of Rui Jin Hospital in 2006 were followed up until December 31, 2016 or death, representing a follow-up period of up to 10 years. Overall and cause-specific standardized mortality ratios (SMR) were calculated, and predictors for survival at disease onset were estimated.
 Results Thirty one patients had died by December 31, 2016, and the SMR at 10 years of follow-up was 0.87 (0.59–1.25). The primary direct cause of death was respiratory disease (SMR = 3.52, 95% CI 1.98–5.78). Employing Cox's proportional hazard modeling, postural instability gait disorder (PIGD) type and older age at onset predicted poor survival in this cohort. Conclusions This finding confirms the similar survival of patients with PD to the control population in the post-levodopa era. PIGD type and older age at onset had a negative impact on survival.