Trends in Parkinsonism related mortality in the United States, 1999-2020

Introduction: Parkinsonism is a complex and diverse spectrum of neurological conditions characterized by motor symptoms that closely resemble those of Parkinson's disease. Patients with Parkinsonism are at an increased risk of mortality. We aimed to assess the trends of parkinsonism-related mortality and identify associated sociodemographic factors in patients with Parkinsonism.

Methods: Death certificates from the CDC WONDER (Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research) database were examined from 1999 to 2020 for Parkinsonism [ICD-10 Codes: G61.0 (Guillain-Barre syndrome); G61.1 (Serum neuropathy); G61.8 (Other inflammatory polyneuropathies); G61.9 (Inflammatory polyneuropathy, unspecified)]. Age-adjusted mortality rates (AAMRs) per 100,000 persons and annual percent change (APC) were calculated and stratified by year, sex, age groups, race/ethnicity, and regional distributions.

Results: Between 1999 and 2020, 12,840 Parkinsonism-related deaths occurred. The AAMR for Parkinsonism increased from 1.604 in 1999 to 2.159 in 2020, with the APC changing from 0.08% (1999-2013) to 6.51% (2013-2020). Males (AAMR: 2.371), on average, showed a higher AAMR than females (AAMR: 1.300). White Americans (AAMR: 1.823) have a greater overall AAMR than African Americans (AAMR: 1.602). African Americans had an initial decline in AAMR from 1999-2014 (APC: -2.41%) but now present a sharp rise from 2014–2020 (APC: 9.15%). In terms of Age groups, 85+-year-olds showed the highest AAMR (17.488) with a rapid incline in recent years from 2015-2020 (APC: 10.38%). Rural populations (AAMR: 2.079) are disproportionally more affected than Urban populations (AAMR: 1.601). There was a massive uptick in Parkinsonism-related AAMR in rural populations from 2018-2020 (APC: 22.57%).

Conclusion : Mortality related to Parkinsonism has risen over the past decade in men, African Americans, and White American populations at a higher risk, emphasizing the need for targeted interventions and continued monitoring of this population.