Parkinsonism and Parkinson's disease in the elderly: A community-based survey in Brazil (the Bambuí study (original) (raw)
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Prevalence of Parkinson's disease in the elderly: The Rotterdam Study
Neurology, 1995
Article abstract-We assessed the prevalence of Parkinson's disease (PD) in a general elderly population in the Netherlands. The study formed part of the Rotterdam Study, a population-based door-to-door study, and included 6,969 persons 55 years of age or older living in a suburb of Rotterdam, the Netherlands. All participants were examined, and those who either had at least one possible cardinal sign of parkinsonism at the neurologic screening, reported that they had PD, or were taking antiparkinsonian drugs were invited for further evaluation. The prevalence of PD in this population was 1.4% (1.2% for men, 1.5% for women). Prevalence increased with age, and prevalence figures were 0.3% for those aged 55 to 64 years, 1.0% for those 65 to 74,3.1% for those 75 to 84, and 4.3% for those 85 to 94. The corresponding age-specific figures for men were 0.4%, 1.2%, 2.7%, and 3.0%, and for women, 0.2%, 0.8%, 3.4%, and 4.8%. Among 95-to 99-year-old women the prevalence was 5.0%. Twelve percent of the subjects with PD were detected through the screening and had not been diagnosed previously.
Prevalence of Parkinson?s disease and other types of Parkinsonism
Journal of Neurology, 2004
Parkinson's disease (PD) is a common neurodegenerative disorder in older people. The prevalence of PD varies among ethnic and geographic groups around the world. In this study, we aimed to estimate the prevalence of PD and other types of Parkinsonism in persons aged 40yearsintheAlKhargadistrictofEgypt.ThestudywasconductedonthetotalpopulationofAlKhargadistrict(62,583persons)between2005and2009andinvolvedthreeneurologyspecialistsand15femalesocialworkersundertakingadoor−to−doorsurvey.SuspectedcasesofParkinsonismweresubjectedtometiculousclinicalandneurologicalexaminationbythreeneurologystaffmembersfromAssiutUniversityhospitalwhocarriedouttheirexaminationsseparately.Ofthetotalpopulationsurveyed,15,482personswereaged40 years in the Al Kharga district of Egypt. The study was conducted on the total population of Al Kharga district (62,583 persons) between 2005 and 2009 and involved three neurology specialists and 15 female social workers undertaking a door-to-door survey. Suspected cases of Parkinsonism were subjected to meticulous clinical and neurological examination by three neurology staff members from Assiut University hospital who carried out their examinations separately. Of the total population surveyed, 15,482 persons were aged 40yearsintheAlKhargadistrictofEgypt.ThestudywasconductedonthetotalpopulationofAlKhargadistrict(62,583persons)between2005and2009andinvolvedthreeneurologyspecialistsand15femalesocialworkersundertakingadoor−to−doorsurvey.SuspectedcasesofParkinsonismweresubjectedtometiculousclinicalandneurologicalexaminationbythreeneurologystaffmembersfromAssiutUniversityhospitalwhocarriedouttheirexaminationsseparately.Ofthetotalpopulationsurveyed,15,482personswereaged40 years and 49 of these were identified as having Parkinsonism (prevalence: 316.50 per 100,000 people [95% confidence interval {CI} 240.21-404.98]). Of the 49, 33 fulfilled the diagnostic criteria for PD, giving a prevalence rate of 213.15/100,000 (95% CI 150.51-285.80) while 14 fulfilled those for vascular Parkinsonism, with a prevalence rate of 90.43/100,000 (95% CI 49.60-137.78). Postencephalitic and unspecified Parkinsonism each had a prevalence rate of 6.46/100,000. The prevalence of Parkinsonism was found to increase steadily with age, and the prevalence of all types of Parkinsonism was statistically higher in rural compared with urban communities, with no significant difference between men and women.
A systematic review of the worldwide prevalence and incidence of Parkinson's disease
PubMed, 2011
Background: A number of epidemiologic studies of Parkinson 's disease (PD) have been conducted worldwide over the years. Although every study reported the rise in prevalence and incidence rate of PD with the increasing age, the overall estimates were different across countries. The variation in reported data may partly be contributed by case ascertainment, case finding method, data collection, and most importantly different population structures. Objective: Systematically review prevalence and incidence of PD and find the causes of variation in the results. Material and method: A literature search was conducted on Medline and EMBASE for studies worldwide investigating the prevalence and incidence of PD and included all adults, English and publication between 1965 and January 2010. The primary search of both databases yielded 5,330 results. After screening topics and abstracts, 168 relevant abstracts were tagged and saved for more thorough perusal. Ultimately, 40 papers were selected for review after applying the pre-specified inclusion criteria Results: The worldwide prevalence of PD varies widely. One reason for the variation in prevalence estimates could be due to the differences in survival across countries. The use of epidemiological studies using medical records could be another reason for the variation in disease frequency. Conclusion: PD is common in the elderly. A number of descriptive epidemiologic studies have been conducted worldwide. Comparing the incidence and prevalence of Parkinson's disease is difficult.
Incidence of Parkinson's disease: variation by age, gender, and race/ethnicity
American Journal of …, 2003
were identified among members of the Kaiser Permanente Medical Care Program of Northern California, a large health maintenance organization. Each case met modified standardized criteria/Hughes diagnostic criteria as applied by a movement disorder specialist. Incidence rates per 100,000 person-years were calculated using the Kaiser Permanente membership information as the denominator and adjusted for age and/or gender using the direct method of standardization. A total of 588 newly diagnosed (incident) cases of Parkinson's disease were identified, which gave an overall annualized ageand gender-adjusted incidence rate of 13.4 per 100,000 (95% confidence interval (CI): 11.4, 15.5). The incidence rapidly increased over the age of 60 years, with only 4% of the cases being under the age of 50 years. The rate for men (19.0 per 100,000, 95% CI: 16.1, 21.8) was 91% higher than that for women (9.9 per 100,000, 95% CI: 7.6, 12.2). The age-and gender-adjusted rate per 100,000 was highest among Hispanics (16.6, 95% CI: 12.0, 21.3), followed by non-Hispanic Whites (13.6, 95% CI: 11.5, 15.7), Asians (11.3, 95% CI: 7.2, 15.3), and Blacks (10.2, 95% CI: 6.4, 14.0). These data suggest that the incidence of Parkinson's disease varies by race/ethnicity.
Parkinson's disease and parkinsonism in a longitudinal study: Two-fold higher incidence in men
Neurology, 2000
al. Stimulation of highaffinity adenosine A 2 receptors decreases the affinity of dopamine D 2 receptors in rat striatal membranes. Proc Natl Acad Sci USA 1991;88:7238 -7241. 37. Ledent C, Vaugeois J-M, Schiffmann SN, et al. Aggressiveness, hypoalgesia and high blood pressure in mice lacking the adenosine A sub 2a receptor. Nature 1997;388:674 -678. 38. Hellenbrand W, Boeing H, Robra B-P, et al. Diet and Parkinson's disease II: a possible role for the past intake of specific nutrients: results from a self-administered food-frequency questionnaire in a case-control study. Neurology 1996;47:644 -650. 39. Sackett DL. Bias in analytic research. J Chronic Dis 1979;32: 51-63. 40. Morens DM, Grandinetti A, Davis JW, et al. Evidence against the operation of selective mortality in explaining the association between cigarette smoking and reduced occurrence of idiopathic Parkinson disease. Am J Epidemiol 1996;144:400 -404. 41. Ellenberg JH. Differential postmorbidity mortality in observational studies of risk factors for neurologic disorders.
Prevalence and incidence of Parkinson's disease in Europe
European Neuropsychopharmacology, 2005
Objective: To provide an overview on the prevalence and incidence of Parkinson's disease (PD) in selected European countries. Background: PD is a common disease of unknown etiology. Accurate information on the epidemiology of PD is critical to inform health policy. An aging population will lead to more patients with PD; thus, the high financial burden PD places on society will increase. Material and methods: A systematic literature search was performed to identify studies on the prevalence and incidence of PD in the following European countriesUnited Kingdom. Only published studies were included. Abstracts, reviews, meta-analyses and letters to the editor were excluded. There were no language restrictions. Data were extracted using a standardized assessment form, and evidence tables were used to systematically report and compare the data. Results: Of 39 identified studies, most (87%) reported estimates of PD prevalence rates, while only a few (13%) reported estimates of PD annual incidence rates. Crude prevalence rate estimates ranged from 65.6 per 100,000 to 12,500 per 100,000 and annual incidence estimates ranged from 5 per 100,000 to 346 per 100,000. No publications could be identified for Austria or the Czech Republic. Discussion and conclusion: The observed variations in prevalence and incidence rates may result from environmental or genetic factors, but might also be a consequence of differences in methodologies for case ascertainment, diagnostic criteria, or age distributions of the study populations. The comparability of existing studies is limited. D
Age-standardized incidence and prevalence of Parkinson's disease in a Swedish community
Journal of Clinical Epidemiology, 1996
Parkinson's disease (PD) h s ows a geographical variation. All prescriptions for anti-parkinsonian drugs were recorded for a half-year in a region with low L-dopa consumption. Hospital and outpatient records were studied and physicians were asked to supply details of PD patients in the region, with 147,777 inhabitants. The crude prevalence was 115 PD per 100,000 inhabitants, based on 170 cases. In contrast to other studies we report an age-standardized prevalence, which was 76 per 100,000, using the European Standard Population as reference. The corresponding approximate incidences were 11.0 (crude) and 7.9 (agestandardized) per 100,000 person-years. Male preponderance appeared in all age groups. Mean age at onset was 65.6 years, the highest figure reported. Variation between studies for age at onset, differences in prevalence, and male preponderance suggest environmental risk factors to be of importance for PD.
Neuropsychiatric Disease and Treatment, 2015
Parkinsonism occurs in all ethnic groups worldwide; however, there are wide variations in the prevalence rates reported from different countries, even for neighboring regions. The huge socioeconomic burden of parkinsonism necessitates the need for prevalence studies in each country. So far, there is neither data registry nor prevalence information on parkinsonism in the Iranian population. The aim of our study was to estimate the prevalence rate of probable parkinsonism in a huge urban area in Iran, Tehran using a community-based door-to-door survey. We used a random multistage sampling of the households within the network of health centers consisting of 374 subunits in all 22 districts throughout the entire urban area of Tehran. Overall, 20,621 individuals answered the baseline checklist and screening questionnaire and data from 19,500 persons aged ≥30 years were entered in the final analysis. Health care professionals used a new six-item screening questionnaire for parkinsonism, which has been previously shown to have a high validity and diagnostic value in the same population. A total of 157 cases were screened for parkinsonism using the validated six-item questionnaire. After age and sex adjustment based on the Tehran population, the prevalence of parkinsonism was calculated as 222.9 per 100,000. Using the World Health Organization's World Standard Population, the standardized prevalence rate of parkinsonism was 285 per 100,000 (95% confidence interval 240-329). The male:female ratio of probable parkinsonism was calculated as 1.62, and there was a significant increase in the screening rate by advancing age. The calculated rates for the prevalence of parkinsonism in our study are closer to reports from some European and Middle Eastern countries, higher than reports from Eastern Asian and African populations, and lower than Australia. The prevalence rate of >200 in 100,000 for parkinsonism in Tehran, Iran could be considered a medium-to-high rate.
Alzheimer's & Dementia, 2012
Background: The incidence of dementia in Parkinson's disease (PD) is not fully known, and previous studies have provided a wide range of rates owing to variations in diagnostic criteria and methodologies used. We estimated the risk of dementia in newly diagnosed cases of PD in a population-based cohort of subjects aged .65 years. Methods: We performed repetitive systematic screening of PD diagnosis, cognitive performances, and clinical dementia during 15 years (at year 0, 3, 5, 8, 10, and 15) in 3726 elderly subjects living at home in southwestern France (PAQUID). Two sets of diagnostic criteria for dementia in PD were considered: Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised criteria and Movement Disorders Society criteria. Results: Forty-four incident cases of PD occurred in the cohort; of these, 18 (41%) developed dementia during a mean follow-up of 6.8 6 3.6 years. Incidence rate of dementia associated with PD was 74 per 1000 patient-years. The cumulative risk of dementia was approximately 25% and 50% after 5 and 10 years of follow-up, respectively. The relative risk for developing dementia in incident PD subjects compared with non-PD subjects was 2.47 (1.55-3.95). Equivalent estimations were obtained with Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised criteria or Movement Disorders Society criteria. Conclusion: PD represents a high-risk stage for dementia in the general population.
Parkinsonism in Older Adults and Its Association With Adverse Health Outcomes and Neuropathology
The journals of gerontology. Series A, Biological sciences and medical sciences, 2015
Mild parkinsonian signs have been documented in community-dwelling older adults without Parkinson's disease. We estimated the proportion of older adults with parkinsonism and examined its association with adverse health outcomes and indices of brain pathology. Four parkinsonian signs were assessed with the motor portion of the Unified Parkinson's Disease Rating Scale in 2,962 older adults who agreed to annual evaluation and brain autopsy. We used Cox proportional hazards models to examine the association of parkinsonism (two or more signs) and possible parkinsonism (one sign) with adverse health outcomes and regression models in 1,160 decedents to examine the association of parkinsonism and neuropathology. At study entry about 25% (N = 776, 26.2%) had parkinsonism and 30% had possible parkinsonism (N = 885, 29.9%). Parkinsonism was strongly related to age. The frequency was 11.8% for people younger than 75 years, 29.1% for those aged 75-84 years, and 43.7% for those aged 85 ...