Journal article
Small Strokes, Big Impact: Excessive Mortality After Acute Ischemic Stroke in Parkinson's Disease
Movement disorders
02/09/2026
DOI: 10.1002/mds.70218
PMID: 41664511
Abstract
Background
Acute ischemic stroke (AIS) in those with Parkinson's disease (PD) is a growing healthcare burden but mortality studies are significantly lacking.
Objective
To map short- and long-term survival, stratified by relevant comorbidities and stroke characteristics.
Methods
Individuals from the United States Veterans Health Administration were included. AIS and PD were defined by validated International Classification of Diseases (ICD) codes, pharmacy data, and encounter type. Covariates included demographics, smoking status, cardiovascular comorbidities, post-traumatic stress disorder, traumatic brain injury, and frailty. Individuals with PD and stroke were matched 4:1 to controls and survival was measured over 10 years. Two percent of strokes were manually reviewed for size, location, and mechanism per TOAST (Trial of Org 10172 in Acute Stroke Treatment) criteria.
Results
A total of 3173 cases of PD and AIS were identified and matched to groups of PD-only, stroke-only, and controls (N = 12,692 each). Survival analysis showed PD-only and stroke-only had a predictable increased mortality (added deaths ranged from 1.9 [0.9, 2.9] to 4.7 [2.9, 6.6] per 100 person-years). PD + stroke showed further increased mortality with distinct timelines at 0–1-, 1–5-, and 5–10-year periods and synergy accounted for 2.9 [0.5, 5.4] to 19.3 [14.0, 24.6] additional deaths across 10 years. Effects persisted after matching for cardiovascular comorbidities, neurotrauma, and frailty. PD + stroke compared with stroke-only had smaller strokes (80.0% vs. 63.2%) and no differences in location, mechanism, or recurrence rates.
Conclusions
Patients with PD and AIS had greater than expected mortality that was independent of comorbidities or stroke characteristics. This may reflect widespread structural and functional deficits that may warrant a targeted therapeutic strategy.
Details
- Title: Subtitle
- Small Strokes, Big Impact: Excessive Mortality After Acute Ischemic Stroke in Parkinson's Disease
- Creators
- Lee E. Neilson - University of IowaChen Lin - Louisiana State University in ShreveportAnusha Mishra - Oregon Health & Science UniversityGregory D. Scott - Oregon Health & Science University
- Resource Type
- Journal article
- Publication Details
- Movement disorders
- DOI
- 10.1002/mds.70218
- PMID
- 41664511
- NLM abbreviation
- Mov Disord
- ISSN
- 0885-3185
- eISSN
- 1531-8257
- Publisher
- Wiley
- Grant note
- U.S. Department of Veterans Affairs (VA) awards: IK2 CX00253, IK2 CX002104, VA I21 RX003612, IK2 BX005760 National Institutes of Health (NIH) awards National Institute of Neurological Disorders and Stroke (NINDS): R01 NS110690 NIH National Institute on Aging (NIA): R01 AG081840 NIH NINDS/NIA: R01 NS134592 VA Parkinson's Disease Research, Education, and Clinical Center (PADRECC)John and Tami Marick Family FoundationOregon Alzheimer's Disease Research Center
U.S. Department of Veterans Affairs (VA) awards IK2 CX00253 (L.E.N.), IK2 CX002104, and VA I21 RX003612 (C.L.); IK2 BX005760 (G.D.S.); and National Institutes of Health (NIH) awards National Institute of Neurological Disorders and Stroke (NINDS) R01 NS110690, NIH National Institute on Aging (NIA) R01 AG081840, and NIH NINDS/NIA R01 NS134592 (A.M.). Additional supported provided by the VA Parkinson's Disease Research, Education, and Clinical Center (PADRECC), the John and Tami Marick Family Foundation, and Oregon Alzheimer's Disease Research Center.
- Language
- English
- Electronic publication date
- 02/09/2026
- Academic Unit
- Neurology
- Record Identifier
- 9985139298302771
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