{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T07:44:29Z","timestamp":1792395869572,"version":"4.4.0"},"reference-count":50,"publisher":"Wiley","issue":"9","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"vor","delay-in-days":22,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Brain and Behavior"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Parkinson's disease (PD) is the second most common neurodegenerative disorder, with increasing prevalence and mortality among older adults. Beyond motor dysfunction, PD contributes to respiratory impairment through muscle weakness, and airway obstruction. Respiratory failure, a major global health burden, is increasingly recognized as a significant cause of fatality in advanced PD.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed PD (ICD\u201010 code: G20) and respiratory failure (ICD\u201010 code: J96)\u2010related mortality in older adults, using the CDC\u2010WONDER database from 1999 to 2020. Age\u2010Adjusted Mortality Rates (AAMR) per 100,000 were calculated and categorized by demographics and region. Joinpoint regression was used to estimate Annual Percent Change and Average Annual Percent Change (AAPC).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 59,168 PD and respiratory failure\u2010related deaths were recorded among older adults aged \u226565 years. The AAMR observed a significantly steep incline from 5.5 in 1999 to 11.38 in 2020 (AAPC: 3.10%; 95% CI: 2.01 to 4.20,\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.01). Men demonstrated higher overall AAMR than women. Among different races and ethnicities, Non\u2010Hispanic White population had the highest overall AAMR. Regionally, the highest overall AAMR was recorded in the West and Metropolitan areas.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>This study highlights a marked rise in PD and respiratory failure\u2010related deaths in the United States, with notable disparities across demographics and regions. Mortality was higher in males and non\u2010Hispanic Whites, with the West and urban areas showing sharp increases, reflecting limited access to special care. These findings underscore widening inequities and the need for targeted policies, equitable resource allocation, and further research on underlying social and healthcare determinants.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/brb3.71756","type":"journal-article","created":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T05:28:03Z","timestamp":1790227683000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Parkinson's Disease and Respiratory Failure: Epidemiologic Insights of Two Decades From the CDC\u2010WONDER Database"],"prefix":"10.1002","volume":"16","author":[{"given":"Maryam","family":"Saghir","sequence":"first","affiliation":[{"name":"M.B.B.S Jinnah Sindh Medical University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amna Amir","family":"Jalal","sequence":"additional","affiliation":[{"name":"M.B.B.S Jinnah Sindh Medical University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eshal","family":"Saghir","sequence":"additional","affiliation":[{"name":"M.B.B.S Dow University of Health Sciences Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kashmala","family":"Rahl","sequence":"additional","affiliation":[{"name":"M.B.B.S Jinnah Sindh Medical University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nida","family":"Shoaib","sequence":"additional","affiliation":[{"name":"M.B.B.S Jinnah Sindh Medical University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Affan","sequence":"additional","affiliation":[{"name":"M.B.B.S Jinnah Sindh Medical University Karachi Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mahtab","family":"Zafar","sequence":"additional","affiliation":[{"name":"M.B.B.S Rahbar Medical and Dental College Lahore Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nara Miriam","family":"Michaelson","sequence":"additional","affiliation":[{"name":"Beth Israel Deaconess Medical Center, Harvard Medical School  Boston Massachusetts USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-8208-0689","authenticated-orcid":false,"given":"Kamil Ahmad","family":"Kamil","sequence":"additional","affiliation":[{"name":"Chief, Internal Medicine Department Nasrat Bashir Curative Hospital  Kandahar Afghanistan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,23]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1212\/CPJ.0000000000200138"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2021.01.032"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/brb3.71190"},{"key":"e_1_2_12_5_1","first-page":"1","article-title":"Age Standardization of Death Rates: Implementation of the Year 2000 Standard","volume":"47","author":"Anderson R. 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