Incidence and mortality of Parkinson's disease in older Canadians

ObjectiveTo estimate the age-specific incidence of Parkinson’s disease (PD) in elderly persons in the Canadian province of British Columbia (BC). All-cause and injury mortalities and relative risk of death for those persons with PD were also examined.MethodsA historical cohort study was conducted using 5 provincial administrative databases from 1991/92 to 2000/2001. A series of algorithms based on the databases were created for case ascertainment of PD for persons 65 years or older. Crude and age-specific incidence and mortality rates were calculated using person-years of follow-up as the denominator. The impact of PD on all-cause and injury mortalities was examined using multivariate Cox regression models to provide adjusted hazard ratios.Results10,910 incidence cases over 6,051,682 person-years of follow-up were identified. The crude annual incidence rate was 252 per 100,000 person-years. Over the nine year period, age standardized incidence for males ranged from 207 to 396 per 100,000 person-years and 127 to 259 per 100,000 person-years for females. Persons with PD were at a 43% greater risk of all-cause mortality and specifically, 51% greater risk of injury mortality.ConclusionsIncidence of PD is substantially higher in advanced age with age adjusted increases for both all-cause and injury mortalities. These findings also highlight falls as a primary factor for injury mortality in PD.     

Incidence of hospitalization for traumatic brain injury in children and adolescents (Valencia Community, Spain, 2002-2009)

INTRODUCTION. Traumatic brain injuries (TBI) are a major cause of morbidity and mortality in children and adolescents but there are hardly any studies on the incidence and temporal evolution. AIM. To describe recent trends (2002-2009) in the incidence of hospitalization for TBI in children and adolescents in the region of Valencia. PATIENTS AND METHODS. Emergency admissions were identified in hospitals in the Valencian Health Agency from patients aged 0-19 years with a diagnosis of TBI (codes of the International Classification of Diseases 800, 801, 803, 804 and 850 to 854) during 2002 to 2009. The severity was classified using the fifth digit of these codes and the crude and standardized rates per 100,000 children were estimated stratified by age, sex and severity. RESULTS. From 2002 to 2009 a total of 5,504 TBI in children up to age of 19 years were hospitalized (mild: 92.9%; moderate to severe: 7.1%). In-hospital mortality was 0.6% for mild TBI and 15.7% for moderate-severe. Crude rates of mild head injury per 100,000 children fell from 85.9 to 55.4 in 2002-2009 (boys: 114.1 to 68.3, girls: 56.1 to 41.8), especially in the 15-19 years. For moderate-severe TBI, rates decreased from 5.73 to 2.78 per 100,000 in 2002-2009 (boys: 8.69 to 3.67; girls: 2.59 to 1.84). CONCLUSIONS. The incidence of pediatric TBI in the Valencia region has decreased significantly in the period 2002-2009, but their medical, legal, societal and family consequences still represents a substantial burden.     

Is the incidence of optic neuritis rising? Evidence from an epidemiological study in Barcelona (Spain), 2008–2012

It is currently believed that the incidence rate of optic neuritis (ON) ranges between 0.56 and 5.1 cases per 100,000 person-years. However, since these figures were generated, they have not been updated and there are suggestions that the incidence of ON is on the rise. When designing new therapies and clinical trials for ON, and to improve the management this disease, it is important to have accurate epidemiological data. Thus, we set out to obtain the prevalence and incidence rates of ON in Barcelona (Spain) from 2008 to 2012, by a retrospective evaluation of electronic hospital records at the Hospital Clinic of Barcelona (population of 300,000 in the catchment area) matching the following ICD-9-CM codes as search terms: 377.3-optic neuritis; 377.30-optic neuritis, unspecific; 377.31-optic papillitis; 377.32-retrobulbar neuritis, acute; 377.39-other optic neuritis and “optic neuropathy”. Demographic and clinical data were collected from records with a confirmed diagnosis of ON, including cases of idiopathic ON, multiple sclerosis, neuromyelitis optica and CRION. The prevalence of acute ON on 31 December 2012 was 2.75 cases per 100,000 people. The mean annual prevalence of acute ON during the 2008–2012 period was 7.87 cases per 100,000 person-year and the mean annual incidence rate was 5.36 cases per 100,000 person-years. The incidence of ON in Barcelona during 2008–2012 was higher than previously reported. This increase may reflect the evolution of diagnostic criteria, the use of a referral-center approach instead of a population-based approach, increased awareness of demyelinating diseases, latitude-related factors and possibly a true increase in its incidence.     

Transition in Incidence Rate of Hospitalised Stroke and Case Fatality Rate in the Hunter Region,Australia, 2001-2019: A Prospective Hospital-Based Study

Introduction: Continuous surveillance of stroke admissions has been conducted in the Hunter region, Australia, over the past two decades. We aimed to describe the trends in incidence rates of hospitalised stroke and case-fatality rates in this region, 2001-2019. Methods: From a hospital-based stroke registry, data for admitted adult stroke patients residing in the Hunter region were collected using ICD-10 codes for ischemic and haemorrhagic stroke. Negative binomial regression and logistic regression analysis were used to analyse trends for age-standardised and age-specific incidence rates of hospitalised stroke and 28-day case-fatality rates. Results: A total of 14,662 hospitalisations for stroke in 13,242 individuals were registered. The age-standardised incidence rate declined from 123 per 100,000 population in the 2001-2005 epoch to 96 in the 2016-2019 epoch (mean annual change -2.0%, incidence rate ratio (IRR) = 0.980 [95%CI: 0.976-0.984]). Age-specific analyses identified significant reduction in the group aged 75-84 (1039 per 100,000 population in 2001-2005 to 633 in 2016-2019, annual change -3.5%, IRR= 0.965 [95%CI: 0.960-0.970]). The 28-day case-fatality rates fluctuated over time (18.5% in 2001-2005, 20.8% in 2010-2015, and 17.8% in 2016-2019).  Projected population aging suggests annual volume of patients with new stroke will increase by 77% by 2041 if incidence rates remain unchanged at the 2016-2019 level. Conclusion: Although age-standardised hospitalised stroke incidence rates have declined in the Hunter region, the health system will face an increase in stroke hospitalisations related to the aging population.     

Incidence and prevalence of amyotrophic lateral sclerosis in Harris County, Texas, 1985-1988

The incidence of amyotrophic lateral sclerosis was determined in Harris County, Texas, for the period 1985 through 1988. Amyotrophic lateral sclerosis cases were ascertained from four sources: area neurologists, hospitals, death certificates, and the Muscular Dystrophy Association. The age-adjusted incidences of 1.27 per 100,000 person-years in males and 1.03 per 100,000 person-years in females were lower than recent rates in the northern US, Canadian, and northern European studies but higher than rates in southern European studies. Comparisons with other recent incidence studies show less uniformity in occurrence of amyotrophic lateral sclerosis, in both the overall rates and in the age- and sex-specific patterns, than was suggested by mortality studies. The incidence of amyotrophic lateral sclerosis among blacks and whites was similar. Hispanic males had incidences similar to white males, although a deficit of female Hispanic cases was found in Harris County. The prevalence of amyotrophic lateral sclerosis peaked in the 65- to 74-year age group at 33 per 100,000 population among males and 19 per 100,000 population for females.     

Incidence and prevalence of motor neuron disease in Coastal and Mountainous Regions,Croatia, 1984–1993. A preliminary survey

In the period 1984–1993, we carried out an incidence and prevalence study of motor neuron disease in Coastal and Mountainous Regions, Croatia. This was the first epidemiological study on motor neuron disease in Croatia. A total of 22 incident cases were identified. The crude annual incidence rate was 0.68 (95% confidence interval 0.43-1.03) per 100,000 person-years; 0.95 (95% confidence interval 0.60-1.43) per 100,000 person-years for men and 0.42 (95% confidence interval 0.26-0.63) per 100,000 person-years for women. The rate adjusted to the European population was 0.63 (95% confidence interval 0.39-0.95) per 100,000 person-years. The age-adjusted incidence in our population is similar to the rates, standardized to the European population, observed in Italy, but lower than recent rates in the US and northern European studies. On 31st December 1993, there were 18 prevalent cases. The prevalence adjusted to the European population was 5.24 (95% confidence interval 3.10-8.28) per 100,000 population.     

Decreasing first-admission rates of schizophrenia among males in Denmark from 1970 to 1984

The first-admission diagnoses of schizophrenia in males aged 15 years and over for the 15-year interval 1970-84, based on annual reports from the Danish Psychiatric Register, showed a highly significant decrease from 12.6 to 8.5 per 100,000, amounting to 37% by regression analysis. The decrease is almost entirely caused by the age group 15-24 years, in which the incidence fell from 30.7 to 14.6 per 100,000. During the same period a remarkable increase in the corresponding first-admission rates of "borderline states" (ICD-8: 301.83, Danish version) and paranoid and unspecified psychoses (ICD-8: 297, 298.9, and 299) was observed, particularly for the age groups 15-24 and 25-34 years. Changes in diagnostic habits accounting for the decreasing schizophrenia incidence among males are discussed.     

Incidence of unprovoked seizures and epilepsy in Iceland and assessment of the epilepsy syndrome classification: a prospective study

BACKGROUND: No population-based incidence studies of epilepsy have studied syndrome classification from the outset. We prospectively studied the incidence of a single unprovoked seizure and epilepsy in the population of Iceland, and applied the syndrome classification endorsed by the International League Against Epilepsy to this population. METHODS: We used a nationwide surveillance system to prospectively identify all residents of Iceland who presented with a first diagnosis of a single unprovoked seizure or epilepsy between December 1995 and February 1999. All cases were classified by seizure type, cause or risk factors, and epilepsy syndrome. RESULTS: The mean annual incidence of first unprovoked seizures was 56.8 per 100,000 person-years, 23.5 per 100,000 person-years for single unprovoked seizures, and 33.3 per 100,000 person-years for epilepsy (recurrent unprovoked seizures). Incidence was similar in males and females. Partial seizures occurred in 40% and a putative cause was identified in 33%. Age-specific incidence was highest in the first year of life (130 per 100,000 person-years) and in those 65 years and older (110.5 per 100,000 person-years). Using strict diagnostic criteria for epilepsy syndromes, 58% of cases fell into non-informative categories. Idiopathic epilepsy syndromes were identified in 14% of all cases. INTERPRETATION: Findings are consistent with incidence studies from developed countries. Although the epilepsy syndrome classification might be useful in tertiary epilepsy centers, it has limited practicality in population studies and for use by general neurologists.     

Incidence of migraine headache: a population-based study in Olmsted County, Minnesota.

To determine the incidence of clinically detected migraine headache in the defined population of Olmsted County, MN, 1979-1981, we screened over 6,400 patient records from several diagnostic rubrics using the unique resources of the Rochester Epidemiology Project for population-based studies. We identified 629 Olmsted County residents who fulfilled the International Headache Society's 1988 criteria for newly diagnosed migraine headache between 1979 and 1981. The overall age-adjusted incidence was 137 per 100,000 person-years for males and 294 per 100,000 person-years for females. The highest incidence in females was among those aged 20 to 24 years (689 per 100,000 person-years), and in males, the highest incidence was among those aged 10 to 14 years (246 per 100,000 person-years). From 1979 to 1981, there was a striking increase in the age-adjusted incidence in those under 45 years of age: the incidence increased 34% in women and 100% for men. This is the first population-based study of migraine incidence across all ages.     

The incidence of deep venous thrombosis and pulmonary embolism among patients with inflammatory bowel disease: a population-based cohort study

BACKGROUND: There is an impression mostly from specialty clinics that patients with inflammatory bowel disease (IBD) have an increased risk of venous thromboembolic disorders. Our aim was to determine the incidence of deep venous thrombosis (DVT) and pulmonary embolism (PE) from a population-based database of IBD patients and, to compare the incidence rates to that of an age, gender and geographically matched population control group. METHODS: IBD patients identified from the administrative claims data of the universal provincial insurance plan of Manitoba were matched 1:10 to randomly selected members of the general population without IBD by year, age, gender, and postal area of residence using Manitoba Health's population registry. The incidence of hospitalization for DVT and PE was calculated from hospital discharge abstracts using ICD-9-CM codes 451.1, 453.x for DVT and 415.1x for PE. Rates were calculated based on person-years of follow-up for 1984-1997. Comparisons to the population cohort yielded age-adjusted incidence rate ratios (IRR). Rates were calculated based on person-years of follow-up (Crohn's disease = 21,340, ulcerative colitis = 19,665) for 1984-1997. RESULTS: In Crohn's disease the incidence rate of DVT was 31.4/10,000 person-years and of PE was 10.3/10,000 person-years. In ulcerative colitis the incidence rates were 30.0/10,000 person-years for DVT and 19.8/10,000 person-years for PE. The IRR was 4.7 (95% CI, 3.5-6.3) for DVT and 2.9 (1.8-4.7) for PE in Crohn's disease and 2.8 (2.1-3.7) for DVT and 3.6 (2.5-5.2) for PE, in ulcerative colitis. There were no gender differences for IRR. The highest rates of DVT and PE were seen among patients over 60 years old; however the highest IRR for these events were among patients less than 40 years. CONCLUSION: IBD patients have a threefold increased risk of developing DVT or PE.     

Epidemiological aspects of spontaneous subarachnoid haemorrhage in Queensland, Australia.

AIMS: To examine the epidemiology of spontaneous subarachnoid haemorrhage (SAH) within the population of Queensland, Australia in 2002. METHODS: A retrospective population and hospital-based survey of all cases of spontaneous SAH occurring within the population of Queensland (3.7 million) during the calendar year 2002 was performed. Cases were identified from hospital separation coding data and the register of births, deaths and marriages. Standard demographic data was recorded for each case identified. RESULTS: The annual incidence of SAH in our population was 9.4 cases per 100,000. There was a steady increase in the incidence of SAH with increasing age, with the incidence rising to 38.8 per 100,000 in those aged greater than 80. The overall mortality rate was 33.1%, with 6% of all cases dying before reaching hospital care. The annual incidence in the indigenous population of Queensland was 8.9 /100,000.     

Contribution of incidence to increasing prevalence of multiple sclerosis in Alberta, Canada

Alberta Health Care Insurance Plan (AHCIP) data were used to calculate prevalence and incidence rates for multiple sclerosis (MS) in the general population of Alberta from 1990 to 2004. Multiple sclerosis prevalence rose steadily each year over this time period, from 217.6/100,000 individuals in 1990 to 357.6/100,000 in 2004. Multiple sclerosis incidence fluctuated with a slight increase from 1990 to 2004, at 20.9/100,000 and 23.9/100,000, respectively. Age-specific prevalence rates were higher between ages 30 and 60 in 2004 than in 1990. The pattern of age-specific incidence rates was similar in 1990 and 2004, with a slight shift toward diagnosis in younger years. Gender-specific prevalence rates were higher for females in both 1990 and 2004, with a greater increase in females (43%) than males (29%). Gender-specific incidence rates were higher for females than males in both years, but there was no differential increase in incidence by gender from 1990 to 2004. The 2004 Alberta MS prevalence rate remains among the highest reported worldwide. Both increasing incidence and longer duration have likely contributed to increasing MS prevalence in the province.     

The incidence of first provoked and unprovoked seizure in pediatric patients with and without psychiatric diagnoses

PURPOSE: To estimate the rate of new-onset afebrile provoked and unprovoked seizure in a general pediatric population and subgroups of patients with and without psychiatric diagnoses other than attention deficit hyperactivity disorder (ADHD). METHODS: A retrospective cohort study of 133,440 pediatric patients, between the ages of 6 and 17 years, and without history of seizure or prior use of anticonvulsant medications, with follow-up during 2003. The data source for this study was Ingenix's research database containing pharmacy and medical claims for members of a large US-based managed care organization. The main outcome measure was new-onset nonfebrile seizure. Incidence rates of seizure and 95% confidence intervals (CI) were calculated and expressed as rates per 100,000 person-years. RESULTS: There were 132 new-onset provoked and unprovoked seizures in 78,423 person-years of follow-up among the general pediatric population sample. The incidence rate of seizure among the general pediatric population was 168 per 100,000 p-y (95% CI 141-200). The incidence rate of seizure among patients without psychiatric diagnoses was 149 per 100,000 p-y (95% CI 122-180). The incidence rate of seizure among patients with psychiatric diagnoses other than ADHD was 513 per 100,000 p-y (95% CI 273-878). There were increases in the incidence rates of seizure in all of the seizure risk factor groups, but this was more pronounced among males ages 6-12 with psychiatric diagnoses. CONCLUSIONS: The results of this study are consistent with previous reports showing that pediatric patients with psychiatric disorders have a higher incidence rate of seizure than the general pediatric population.     

A reappraisal of the epidemiology of multiple sclerosis in Olmsted County, Minnesota

A review of multiple sclerosis (MS) case reports, using the unified record system at the Mayo Clinic for the Olmsted County population, revealed age- and sex-adjusted prevalence rates per 100,000 persons of 160 for Olmsted County and 173 for Rochester, Minnesota, on January 1, 1985. The annual age- and sex-adjusted incidence rate per 100,000 person-years from 1975 to 1984 for Olmsted County was 6.2 and for Rochester, 6.3. This incidence rate is significantly higher than what had been reported previously in Rochester (3.6/100,000) or in other communities. The estimated 25-year survival of the MS population was 76.2% +/- 4.5% compared with 87.7% for the general US white population of a similar age and sex. Survival for men was less than for women. There was no increase in survival for patients diagnosed with MS in more recent decades. No significant increase was found in cancer or autoimmune disease rates in the MS patients.     

Incidence of adult epilepsy in Estonia

PURPOSE: To estimate the main incidence-related characteristics of epilepsy in an adult population in Estonia. Epidemiologic data about epilepsy from central and eastern Europe is controversial. METHODS: All existing databases and lists in the area were reviewed to identify all persons with newly diagnosed epilepsy aged > or =20 years during 3 years. Special attention was paid to extensive adoption of definitions and criteria proposed by Guidelines for epidemiologic studies. RESULTS: Crude and age-adjusted incidence rates were 35 per 100,000 person-years. The age-specific rates tended to increase with advancing age. Of the seizure types, partial seizures had highest rates, 27 per 100,000. The largest syndromic categories were localization-related epilepsies. Risk factors for epilepsy were identified in 55.5% cases. CONCLUSIONS: Incidence-related characteristics in the adult population of Tartu was comparable with those reported from the developed countries. The predominance of localization-related syndromes and partial seizures is the result of age distribution of the study.     

Motor neuron disease in the Province of Turin, Italy, 1971-1980

The incidence and prevalence of motor neuron disease (MND) in the Province of Turin, North-West Italy, were investigated for the period 1971-1980. The crude incidence rate of MND was 0.67/100,000/year. The annual incidence rate, age and sex adjusted to the Italian population in 1971 was 0.69 cases per 100,000 inhabitants, 0.94 for men and 0.45 for women, with a male to female incidence ratio of 2.09:1. The prevalence of MND was 2.62/100,000, 3.57 for males and 1.71 for females. The mean age at the time of diagnosis was 55.6 years. Annual incidence rates increased with advancing age. Amyotrophic lateral sclerosis was found to be 4 times more frequent than progressive muscular atrophy (0.53/100,000/year v. 0.14/100,000/year). The distribution of MND was uneven in the Province suggesting a proportional relationship to the distribution of population density. Possible explanations of this finding are discussed.     

Incidence and prevalence of ALS in Ireland, 1995-1997: a population-based study

BACKGROUND: We conducted a prospective, population-based study of ALS in the Republic of Ireland for the 3-year period 1995 to 1997. METHODS: To ensure complete case ascertainment, multiple sources of information were used, including consultant neurologists, neurophysiologists, primary care physicians, and the Irish Motor Neuron Disease Association. The El Escorial diagnostic criteria for ALS were applied to all cases enrolled on the register and each patient was regularly followed up during his or her illness. RESULTS: Between January 1, 1995, and December 31, 1997, 231 patients were diagnosed with possible, probable, or definite ALS, including 133 men (57.6%) and 98 women (42.4%). The average annual incidence rate was 2.1 per 100,000 person-years (95% CI, 1.8 to 2.4), and 2.8 per 100,000 person-years for the population older than 15 years (95% CI, 2.4 to 3.1). The incidence rate was higher for men, being 2.5 per 100,000 person-years (95% CI, 2.0 to 2.9), than for women, at 1.8 per 100,000 person-years (95% CI, 1.5 to 2.2), and increased with age for both sexes. The median age at onset was 64.2 years for men and 67.8 years for women. On December 31, 1996, the crude prevalence was 4.7 per 100,000 of the total population (95% CI, 4.0 to 5.5), and 6.2 per 100,000 for the population older than 15 years (95% CI, 5.3 to 7.1). Adjusting to the 1996 Irish population as standard, the incidence of ALS in Ireland during the 3-year study period is the third highest reported to date. CONCLUSIONS: There was a trend toward a higher incidence of ALS in the northwestern region of Ireland, although the numbers of cases involved were small and further study is required.     

Epidemiologic data on meningiomas in East Germany 1961-1986: incidence, localization, age and sex distribution.

From 1961 to 1986, 8119 new cases of meningioma were reported to the National Cancer Register of East Germany (former German Democratic Republic) with an average population of 16.9 million. The crude annual incidence was 1.85 per 100,000 population. The crude rates were 1.16 for males, and 2.44 per 100,000 for women; after age adjustment ("world" population) these rates were 0.90 and 1.92 per 100,000, respectively. Thus meningioma occurred 2.1 times more frequently in women than men. Independent of sex, the incidence rose continuously with increasing age. At the same time, there appeared to be an increase in meningioma frequency in the course of the 26-year reporting period. The overwhelming majority of cases, 7375, (90.8%) were intracranial in location but 711 (8.8%) were intraspinal. Some 50% of all cases were first discovered at autopsy, with the proportion of such cases being markedly higher in the older age groups.     

Incidence and effectiveness of cerebrospinal fluid shunts in Olmsted County, Minnesota, 1956-1981

In the period 1956 through 1981, 129 cerebrospinal fluid (CSF) shunt operations were performed on 50 patients who were residents of Olmsted County, Minn. The overall average annual age- and sex-adjusted incidence of initial CSF shunts during this 26-year period was 2.3 per 100,000 person-years. Within 5-year calendar time intervals, the average annual incidence rates per 100,000 person-years ranged from 0.8 (1956-1960) to 4.6 (1971-1975). There were 4 shunt-related deaths, 1 due to a CSF shunt infection and 3 due to acute increases in intracranial pressure. In this analysis of shunt procedures in a defined population, the diagnostic indications and changes over time in CSF shunting devices are also described.