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Table 1_Parkinson’s disease mortality in the United States, 1999–2025: a national multiple-cause-of-death analysis with projections to 2030.docx Eshal Atif (23162272) Vishan Das (24404222) Mazhar Ali (11529964) Abdal Ahmad (23162248) Kaneez Fatima (625825) Mohib Ali Hassan (25151631) Muhammad Mukhlis (22392187) Danyal Ahmad (23162263) Mohammad Dawar Zahid (25151634) Sadia Qazi (23162245) Muhammad Atif Mazhar (23162275) Mohammad Sunoqrot (8292156) Akef Obeidat (19176769) Neurology and Neuromuscular Diseases forecasting health disparities joinpoint regression long-term care mortality palliative care Parkinson’s disease Background<p>Parkinson’s disease (PD) is the second most common neurodegenerative disorder in the United States and a growing driver of late-life disability and death. We characterized U.S. PD-related mortality from 1999 to 2025 and projected it to 2030.</p>Methods<p>In this serial cross-sectional analysis of CDC WONDER Multiple Cause of Death data, PD-related deaths in adults aged ≥45 years were identified using ICD-10 code G20 recorded anywhere on the death certificate. Age-adjusted mortality rates (AAMRs) per 100,000 were decomposed by joinpoint regression and projected to 2030 using a log-scale ensemble weighted by rolling-origin back-test error, stratified by sex, age, race and ethnicity, census region, and degree of urbanization.</p>Results<p>Among 1,149,731 PD-related deaths (59.8% men), the overall AAMR was 32.74 in 1999 and 41.03 (95% CI 40.70–41.35) in 2025, but the full-window trend was not significant (average annual percent change 0.56%; −0.10 to 1.22; p = 0.099). A steep 2014–2021 rise (annual percent change 4.70%; p < 0.001) was followed by a non-significant decline, negative in 13 of the 14 strata observed through 2025. COVID-19 was co-listed on 10.15% of PD-mentioned deaths in 2020 and 0.79% in 2025, accounting for 58% of the 2019–2020 rise and 55% of the 2021–2024 decline; excluding these deaths the series was close to flat (39.88 in 2020; 40.71 in 2025). The projected 2030 AAMR was 41.73 (95% prediction interval 33.97–51.27), essentially unchanged from 2025; however, deaths are projected to rise from 62,162 to 70,825, with approximately 87% of the increase attributable to population aging. Restricting to PD as the underlying cause gave a steeper increase (+86.2% versus +25.3%), arguing against ascertainment drift. Between 1999–2007 and 2017–2025, nursing home deaths fell from 49.24 to 35.48%, while home deaths rose from 19.37 to 34.93% and hospice deaths from 0.88 to 8.25%.</p>Conclusion<p>Age-adjusted PD-related mortality did not change significantly between 1999 and 2025. Most of the post-2021 decline reflects the unwinding of COVID-19 co-listing rather than an improvement in underlying mortality, a mechanism that is now nearly exhausted. Projections indicate a plateau in the standardized rate, while absolute deaths rise with population aging, and end-of-life care has shifted from institutions to homes.</p> 2026-10-01T04:24:41Z Dataset Dataset 10.3389/fneur.2026.1934146.s001 https://figshare.com/articles/dataset/Table_1_Parkinson_s_disease_mortality_in_the_United_States_1999_2025_a_national_multiple-cause-of-death_analysis_with_projections_to_2030_docx/34038096 CC BY 4.0