Why Has Mortality Linked to Respiratory Diseases and Parkinson’s Increased After 2018 in the United States
In the United States, the number of deaths among people over 65 suffering from both respiratory diseases and Parkinson’s disease showed a concerning trend between 1999 and 2020. For nearly two decades, age-adjusted mortality rates steadily declined, dropping from 33.1 to 21.3 per 100,000 people. However, starting in 2018, this trend reversed abruptly, with a sharp increase reaching 28.6 in 2020. This sudden rise coincides with the onset of the COVID-19 pandemic, but other factors may also explain this shift.
Men have consistently shown higher mortality rates than women. White individuals recorded the highest rates among racial groups, while the Midwest and Northeast regions were the hardest hit in 2020. States like Nebraska and Vermont had the highest rates in the country that year.
Parkinson’s disease does not only affect movement. It can also disrupt breathing, make coughing less effective, and increase the risk of aspiration, which promotes pneumonia and respiratory failure. Conversely, chronic respiratory diseases worsen motor symptoms and fatigue in people with Parkinson’s, creating a vicious cycle that further weakens their health.
Between 1999 and 2012, the decline in mortality can likely be attributed to better care, improved management of swallowing disorders, and wider vaccination against respiratory infections. Yet, after 2018, the situation deteriorated. The pandemic played a major role, as people with Parkinson’s are more vulnerable to viral infections due to their respiratory difficulties and weakened immune systems. Severe flu outbreaks, an aging population, and unequal access to specialists also contributed to this increase.
Geographic and racial disparities are pronounced. Non-Hispanic Whites have the highest mortality rates, possibly due to better disease screening. Meanwhile, Blacks and Hispanics, though less affected overall, experienced a steeper increase between 2018 and 2020, suggesting inequalities in access to care. Rural areas, where neurologists and pulmonologists are fewer, were particularly affected.
These findings highlight the importance of strengthening respiratory infection prevention among elderly individuals with Parkinson’s. Measures such as regular lung assessments, targeted vaccination programs, and better coordination between neurologists and pulmonologists could improve their life expectancy and quality of life. Increased monitoring of these patients, especially during epidemics, remains essential to prevent further deterioration of the situation.
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Original Publication
DOI: https://doi.org/10.1186/s12982-026-01673-z
Title: Mortality trends due to respiratory and Parkinson’s disease among patients in United States: a 22 year retrospective analysis
Journal: Discover Public Health
Publisher: Springer Science and Business Media LLC
Authors: Muhammad Khubaib Iftikhar; Shah Bano; Kainat Amjad; Fatima Baig; Mirza Mohammad Ali Baig; Bilal Tariq; Sahil Jairamani; Shankar Biswas