Table 2

Summary of predictors of mortality for Parkinson’s and related disorders

DomainDescriptionAssessmentReference
Demographic and clinical markersAge at onset/duration of disease>61 years of age at onset3 5 9 11 37 42 45 46 52
Chronological age78–85 years of age6 10 43
SexMale3 9–11 17 37 39 46 47 62
Body mass index (BMI)Accelerated decrease in BMI for patients with PD (18.5–25 kg/m2)21
Comorbid illnessCongestive heart failure, diabetes mellitus, pressure ulcers, cardiovascular disease6 10 37 38 44–46 58 61
Prescribing shiftShift to fewer dopaminergic medications from previous visits (ie, ≤2)21
Motor symptoms and global disabilityHoehn and Yahr Scale (H&Y)H&Y stage increases (from stages 3–5 at first assessment)43 53
Postural instability gait disorderIncrease in scores from baseline as low as 1 unit on Tinetti balance and gait assessment and SPES/SCOPA5 9 37 42 46 65
Unified Parkinson’s Disease Rating Scale (UPDRS)Significant increases in overall UPDRS Score (≥10 point increase in total scale score over first assessment)11 39 41 43 62
Activities of daily livingSevere score (2 or less)10
Palliative Outcomes Scale (POS)Upward trajectory of POS scores compared with first assessment13
Progressive Supranuclear Palsy Rating Scale (PSPRS)Significant increases in PSPRS scores over 3547
Falls and infectionsFracture riskFractures in previous 3–5 years with attention to fracture site (upper limb, lower limb, hip)4 60
History of infectionsPneumonia diagnosis38 40 43 45 46 51 56 60 61
Sepsis or urosepsis6
Non-motor symptomsDementia/cognitive impairmentDiagnosis in medical record history using DSM classification; MMSE Score≤24; SCOPA-COG<23; severe cognition from CPS5 9 10 16 17 42 52 53 55 56 58 62 66–68
Visual hallucinations; vision problemsUPDRS I question 2 with a score≥2; SCOPA-PC: presence in past month of hallucinations, illusions, paranoid ideation or altered dream phenomena; diagnosis if rapid eye movement sleep behaviour disorder; >2 medical claims for psychosis5 9 10 14 54 59 62 69
DysphagiaUPDRS II question 3 with a score≥2 and correlated with clinical assessment; survey of caretakers5 60
Neurologic bladder disturbances
Stridor (in MSA)
Incontinence and incomplete bladder emptying
Clinical observation; laryngoscopy
8 38 70
  • DSM, Diagnostic and Statistical Manual; MMSE, Mini-Mental Status Exam;80 SPES/SCOPA, Short Parkinson’s Evaluation Scale/Scales for Outcomes in Parkinson’s disease;81 SCOPA-PC, SCOPA-Psychiatric Complications;69 SCOPA-COG, SCOPA-Cognition;82 CPS, Cognitive Performance Scale.83

  • MSA, multiple system atrophy; PD, Parkinson’s disease.