Abstract Details

Title Survival Differences Among Patients with Parkinson’s Disease and Parkinson’s Disease Psychosis: a Population-based Study (2006-2015).

Topic Movement Disorders

Presentation(s) P4 - Poster Session 4 (8:00 AM-9:00 AM)

Poster/Presentation
Number 5-007

Objective To investigate survival rates and symptoms in Parkinson’s Disease (PD) and Parkinson’s Disease Psychosis (PDP).

Background Psychosis is common in PD patients and may affect their quality of life. However, few studies have investigated the effects of psychosis in PD on survival within a population-based cohort.

Design/Methods We used the Rochester Epidemiology Project to define a population-based cohort of PD from 2006-2015 in Olmsted County, MN. A movement disorder specialist reviewed all the clinical records to confirm the diagnosis of PD. PDP was diagnosed using the NINDS/NIMH unified criteria.

Results

We found 69 cases of PDP out of 225 cases of PD (31%). Mortality from any causes was higher in PDP as compared to PD (HR= 4.79, p= 0.005) without significant differences between males and females; however, a 5-year increase in age at PD onset was associated with a higher risk of mortality (HR= 2.39, p< 0.001).
PDP patients showed higher rates of cognitive impairment (40.6% vs 25.6%, p=0.024) and orthostatic hypotension (26.1% vs 14.7%, p=0.042) as compared to PD; no differences in rates of falls (p=0.63), chronic dizziness (p=0.54), or somnolence (p=0.13) were observed. Of the 69 PDP patients (n=69), n=31 (45%) were prescribed antipsychotic treatment; there were no observed statistically significant differences between PDP treated vs untreated with antipsychotic medications in terms of: falls (p= 0.40), dizziness (p= 0.70), somnolence (p=0.59), cognitive impairment (p=0.17), or orthostatic hypotension (p=0.44).

Conclusions Psychosis is associated with a higher risk of all-causes mortality in PD; age of onset of PD influences the mortality risk. PDP may be at greater risk of developing neuropsychiatric symptoms (e.g. cognitive impairment) and/or additional nonmotor symptoms (e.g. orthostatic hypotension) as compared to PD without psychosis. In this cohort, 55% of PDP patients were not treated with antipsychotics.

Authors/Disclosures
Cole D. Stang PRESENTER	Mr. Stang has nothing to disclose.
Emanuele Camerucci, MD (Kansas University Medical Center)	Dr. Camerucci has nothing to disclose.
Aidan Mullan (Mayo Clinic)	Aidan Mullan has nothing to disclose.
	No disclosure on file
Pierpaolo Turcano, MD (Rush University Medical Center)	Dr. Turcano has nothing to disclose.
James H. Bower, MD, MSc, FAAN (Mayo Clinic)	The institution of Dr. Bower has received research support from Abbvie.
Bradley F. Boeve, MD, FAAN (Mayo Clinic)	Dr. Boeve has received personal compensation in the range of $10,000-$49,999 for serving as an officer or member of the Board of Directors for Rainwater Charitable Foundation. The institution of Dr. Boeve has received research support from Alector. The institution of Dr. Boeve has received research support from EIP Pharma. The institution of Dr. Boeve has received research support from Transposon. The institution of Dr. Boeve has received research support from Cognition Therapeutics. Dr. Boeve has received publishing royalties from a publication relating to health care.
Rodolfo Savica, MD, PhD, FAAN (Mayo Clinic)	The institution of Dr. Savica has received research support from ACADIA Pharmaceuticals, Inc.

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