TOPLINE

In patients with late-stage Parkinson's disease (PD), survival declined steadily over follow-up. Aspiration pneumonia was the main cause of death, and worse motor function, cognition, and depressive symptoms independently predicted a higher risk for mortality.

METHODOLOGY

• A researcher in Sweden prospectively followed 107 patients (median age, 78 years; 58% men) with late-stage PD for up to a decade to assess the rate of mortality, main causes of death, and factors associated with a higher risk for morality.
• Late-stage PD was defined as Hoehn and Yahr stages 4-5 while on medication and/or 50% or less independence in daily tasks assessed using the Schwab and England Activities of Daily Living scale.
• Data were collected through home visits at baseline. Medical and mortality records were reviewed at 6, 12, and 18 months; then annually; and at a final follow-up of 7-9 years later to capture mortality status and causes of death.
• Motor symptoms, cognition, and depressive symptoms were assessed using standardised scales.

TAKEAWAY

• At 3 years from baseline, 54% of patients remained alive; this rate fell to 31% at 5 years and 15% at 7 years. Only 8% remained alive at the final follow-up; 57% of the deceased were men.
• Aspiration pneumonia was the leading cause of death, accounting for 34% of deaths, highlighting the substantial burden of swallowing difficulties in late-stage PD; other causes included sepsis (16%), unspecified pneumonia (13%), ileus (5%), and COVID (5%).
• After adjustments, worse motor function (P = .001), depressive symptoms (P = .023), and cognition (P = .042) were independently associated with a higher risk for mortality.

IN PRACTICE

"The present real-world, end-of-life data on late stage PD may provide treating clinicians with awareness and enhanced knowledge on factors associated with higher mortality hazard in this population, in order to better recognize these in the clinic and to optimize treatment and care," the author wrote.

SOURCE

This study was led by Kristina Rosqvist, Division of Neurology, Lund University, Lund, Sweden. It was published online on June 26, 2026, in the Journal of Parkinson's Disease.

LIMITATIONS

The cohort included 10 participants with unknown survival status at the final follow-up, which may have affected mortality estimates. Data on the main cause of death for 17 participants could not be obtained as medical records were unavailable outside the healthcare region.

DISCLOSURES

This study did not receive any specific funding. The author declared having no conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.