Prognosis in Parkinson's Disease: An Individual Patient Data Meta‐Analysis of Six European Incidence Cohorts
Year: 2026
Type: article
Abstract: BACKGROUND: An accurate understanding of prognosis in Parkinson's disease (PD) is important for patient information provision, personalized treatment, and clinical trial design, but most previous research has been biased towards younger, healthier patients. OBJECTIVES: To describe key clinical outcomes longitudinally and identify baseline prognostic factors (predictors) for these outcomes using population-representative PD cohorts. METHODS: We meta-analyzed individual patient data from six incidence cohorts in Western Europe (Norway, Sweden, and UK). Each cohort aimed to recruit and follow up all newly diagnosed cases in defined population/incidence periods (between 2000 and 2011). We described postural instability (Hoehn & Yahr Stage 3), functional dependency (needing help with daily activities), dementia, and death with up to 12 years' follow-up and investigated clinical and genetic predictors using frailty Cox models. RESULTS: In 883 population-based incident patients, median age at motor symptom onset was 69.2 years. Median time to postural instability and functional dependency was 7.4 years. Dementia affected 49.6% by 10 years and 54.7% had died by 12 years (median survival 9.4 years). Older age, higher Movement Disorder Society-Unified Parkinson's Disease Rating Scale-Part III (MDS-UPDRS-III) score, and lower Mini-Mental State Examination (MMSE) were significantly associated with all outcomes; cognitive symptoms and GBA polymorphisms with each outcome except mortality; and APOE ε4 with increased mortality and dementia. CONCLUSIONS: This first individual patient data meta-analysis of population-based incidence cohorts provides robust prognostic data, with fewer selection biases than previous PD studies, for informing people with PD about prognosis. In incidence cohorts, overall PD prognosis is worse than previously suggested, with key outcomes often occurring early. Further work should develop validated prognostic models for objective stratification of prognostic risk and for personalized medicine. © 2026 The Author(s). Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
Source: Movement Disorders
DOI: 10.1002/mds.70303
Language: English
Subfield: Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,480
Funders: Michael J. Fox Foundation for Parkinson's Research, Parkinson Research Foundation, Teva Pharmaceutical Industries, International Parkinson and Movement Disorder Society, Wellcome Trust, Scottish Government, LifeArc, Weston Brain Institute, Kempe Foundation, Intercept Pharmaceuticals, National Institute for Health and Care Research, Medical Research Scotland, Parkinson's UK, Bupa Foundation, British Medical Association, Academy of Medical Sciences, Tenovus, Newcastle University, European Commission, Cambridge University Hospitals, Västerbotten Läns Landsting, Newcastle upon Tyne Hospitals NHS Foundation Trust, Hjärnfonden, Helse Vest, Evelyn Trust, Bupa Health Foundation, Umeå Universitet, Norges Forskningsråd, International Society for Neurochemistry, H. Lundbeck A/S, Parkinsonfonden, Chief Scientist Office, Scottish Government Health and Social Care Directorate, Medical Research Council, NIHR Newcastle Biomedical Research Centre, NIHR Cambridge Biomedical Research Centre
Awards: G1147289410, G139696651, G1973957958, G2119527137, G2493601830, G2537968379, G299057155, G3025080674, G3046909538, G3204733030, G336534749, G3570280960, G3584577881, G370598735, G3943590970, G3967042023, G4355276853, G4753630297, G4900523628, MRC Transition Support Award: The NET-PDD study - defining the roles of NEuroinflammation and Tau aggregation in Parkinson's Disease Dementia, G6077662935, G617617005, G6309264553, G6552962396, G6629560881, G6641991021, G6793551347, G7453354274, G7776297143, G7826725679, G8119869401
OpenAlex ID: W7153600160