Journal of Neurology

, Volume 260, Issue 1, pp 62–70 | Cite as

Estimation of Parkinson’s disease survival in Israeli men and women, using health maintenance organization pharmacy data in a unique approach

  • O. Chillag-Talmor
  • N. Giladi
  • S. Linn
  • T. Gurevich
  • B. El-Ad
  • B. Silverman
  • N. Friedman
  • C. Peretz
Original Communication

Abstract

The aim of this work was to estimate in an incident cohort of pharmacy-based PD patients the survival of men and women accounting for age at treatment initiation and to compare their gender-specific survival with that of the general Israeli population. A population-based cohort of 4,848 incident pharmacy-based PD cases with definite/probable/possible certainty was previously identified using a drug-tracer approach for 1999–2008. Survival analysis was performed for two time scales: survival after treatment initiation (disease duration), and life-time survival (life expectancy). Kaplan–Meier curves and Cox regressions were used to compare survival across gender. Gender-specific SMRs were calculated from national rates and were compared using Poisson regression. During the follow-up from first purchase of any anti-parkinsonian drug (mean 4.0 ± 2.6 years, range 2 months–10 years), 1,266 (26 %) of the cases died. Younger age at first anti-parkinsonian drug purchase and female gender were associated with increased survival after treatment initiation (HR = 1.089, 95 % CI 1.080–1.098 for 1-year age increase; HR = 0.716, 95 % CI 0.640–0.800, females vs. males). Life-time survival increased with older age at first anti-parkinsonian drug purchase and female gender (HR = 0.759, 95 % CI 0.746–0.771 for 1-year age increase; HR = 0.694, 95 % CI 0.621–0.776, females vs. males). Sensitivity analysis on a sub-cohort of definite cases (n = 2501) yielded similar results. In comparison to the general Israeli population, mortality among pharmacy-based PD patients was significantly increased (SMRmen = 1.69, 95 % CI 1.57–1.81, SMRwomen = 1.49, 95 % CI 1.37–1.62), differently between genders (p < 0.01). Female gender was associated with longer, perhaps more benign disease course, and longer life expectancy. Earlier age at anti-parkinsonian drug initiation increased disease duration, but was associated with shorter life expectancy.

Keywords

Parkinson’s disease Prognosis Cohort studies Incidence studies 

References

  1. 1.
    Ishihara LS, Cheesbrough A, Brayne C, Schrag A (2007) Estimated life expectancy of Parkinson’s patients compared with the UK population. J Neurol Neurosurg Psychiatry 78:1304–1309PubMedCrossRefGoogle Scholar
  2. 2.
    Brandt-Christensen M, Kvist K, Nilsson FM, Andersen PK, Kessing LV (2006) Use of antiparkinsonian drugs in Denmark: results from a nationwide pharmacoepidemiological study. Mov Disord 21:1221–1225PubMedCrossRefGoogle Scholar
  3. 3.
    Chillag-Talmor O, Giladi N, Linn S et al (2011) Use of a refined drug tracer algorithm to estimate prevalence and incidence of Parkinson’s disease in a large Israeli population. J Parkinson’s Dis 1:35–47Google Scholar
  4. 4.
    Israel Central Bureau of Statistics (2010). Complete life tables of Israel, 2004–2008. JerusalemGoogle Scholar
  5. 5.
    Taeger D, Sun Y, Keil U, Straif K (2000) A stand-alone windows applications for computing exact person-years, standardized mortality ratios and confidence intervals in epidemiological studies. Epidemiology 11:607–608PubMedCrossRefGoogle Scholar
  6. 6.
    Elbaz A, Bower JH, Peterson BJ et al (2003) Survival study of Parkinson disease in Olmsted County Minnesota. Arch Neurol 60:91–96PubMedCrossRefGoogle Scholar
  7. 7.
    Louis ED, Bennett DA (2007) Mild Parkinsonian signs: an overview of an emerging concept. Mov Disord 22:1681–1688PubMedCrossRefGoogle Scholar
  8. 8.
    Forsaa EB, Larsen JP, Wentzel-Larsen T et al (2010) What predicts mortality in Parkinson’s disease? A prospective population-based long-term study. Neurology 75:1270–1276PubMedCrossRefGoogle Scholar
  9. 9.
    Shulman LM, Bhat V (2006) Gender disparities in Parkinson’s disease. Expert Rev Neurother 6:407–416PubMedCrossRefGoogle Scholar
  10. 10.
    Chen H, Zhang SM, Schwarzschild MA, Hernan MA, Ascherio A (2006) Survival of Parkinson’s disease patients in a large prospective cohort of male health professionals. Mov Disord 21:1002–1007PubMedCrossRefGoogle Scholar
  11. 11.
    Guttman M, Slaughter PM, Theriault ME, DeBoer DP (2001) Naylor CD Parkinsonism in Ontario: increased mortality compared with controls in a large cohort study. Neurology 57(12):2278–2282PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2012

Authors and Affiliations

  • O. Chillag-Talmor
    • 1
  • N. Giladi
    • 2
    • 5
  • S. Linn
    • 1
    • 4
  • T. Gurevich
    • 2
    • 5
  • B. El-Ad
    • 4
  • B. Silverman
    • 4
  • N. Friedman
    • 4
  • C. Peretz
    • 3
  1. 1.School of Public HealthUniversity of HaifaHaifaIsrael
  2. 2.Department of NeurologyTel Aviv Sourasky Medical CenterTel AvivIsrael
  3. 3.Department of Epidemiology, School of Public Health, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael
  4. 4.Maccabi Healthcare ServicesTel AvivIsrael
  5. 5.Department of Neurology, Sackler Faculty of MedicineTel Aviv UniversityTel AvivIsrael

Personalised recommendations