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Latent class analysis (LCA) delineated subtypes based on score patterns across baseline motor, cognitive, and psychiatric measures. Discriminant analyses identified key features that distinguish subtypes at baseline. Cox regression models tested PD subtype differences in longitudinal conversion to clinical milestones, including deep brain stimulation (DBS), dementia, and mortality.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>LCA identified distinct subtypes: \u201cmotor only\u201d (<jats:italic>N<\/jats:italic>\u00a0=\u00a063) characterized by primary motor deficits; \u201cpsychiatric &amp; motor\u201d (<jats:italic>N<\/jats:italic>\u00a0=\u00a017) characterized by prominent psychiatric symptoms and moderate motor deficits; \u201ccognitive &amp; motor\u201d (<jats:italic>N<\/jats:italic>\u00a0=\u00a082) characterized by impaired cognition and moderate motor deficits. Depression, executive function, and apathy best discriminated subtypes. Since enrollment, 22 had DBS, 48 developed dementia, and 46 have died. Although there were no subtype differences in rate of DBS, dementia occurred at a higher rate in the \u201ccognitive &amp; motor\u201d subtype. Surprisingly, mortality risk was similarly elevated for both \u201ccognitive &amp; motor\u201d and \u201cpsychiatric &amp; motor\u201d subtypes compared to the \u201cmotor only\u201d subtype (relative risk\u00a0=\u00a03.15, 2.60).<\/jats:p><\/jats:sec><jats:sec><jats:title>Interpretation<\/jats:title><jats:p>Psychiatric and cognitive features, rather than motor deficits, distinguish clinical PD subtypes and predict greater risk of subsequent dementia and mortality. These results emphasize the value of multi\u2010domain assessments to better characterize clinical variability in PD. Further, differences in dementia and mortality rates demonstrate the prognostic utility of PD subtypes.<\/jats:p><\/jats:sec>","DOI":"10.1002\/acn3.51102","type":"journal-article","created":{"date-parts":[[2020,6,30]],"date-time":"2020-06-30T02:11:47Z","timestamp":1593483107000},"page":"1272-1283","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":42,"title":["Parkinson disease clinical subtypes: key features &amp; clinical milestones"],"prefix":"10.1002","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3030-9669","authenticated-orcid":false,"given":"Meghan C.","family":"Campbell","sequence":"first","affiliation":[{"name":"Department of Neurology Washington University School of Medicine St. Louis MO"},{"name":"Department of Radiology Washington University School of Medicine St. Louis MO"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter 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