Incidence of Parkinson's disease in estonia

The incidence of Parkinson's disease (PD) was studied over a 9-year period (1990-1998) in Tartu county, Estonia, with a mean population of 156,417. Based on 264 patients, the average crude incidence rate of PD was 18.8 per 100,000 person-years. The age-adjusted incidence was 16.8/100,000; 18.3 for the urban group and 14.0 for the rural group; 16.6 for men and 17.1 for women. The age-specific incidence was 1.0/100,000 in the age range 30-39 years, reached a maximum of 117.2/100,000 in the age range 70-79 years and declined in the elderly. The incidence of PD was comparable with that found in developed countries, except for a slightly higher (not significant) incidence rate in the urban compared with the rural population in Estonia.     

The prevalence of Parkinson's disease in rural Tanzania

The prevalence of Parkinson's disease (PD) varies worldwide from 7 to 450 per 100,000, and appears low in sub‐Saharan Africa (SSA) but few data exist. We conducted a prevalence study of PD in rural Tanzania. A door‐to‐door study was conducted in the Hai district project area (population 161,071), using a screening questionnaire followed by structured history and examination of positive responders. Diagnosis was based on the UK PD Society Brain Bank Criteria. 33 (23 men) cases of PD were detected, with mean age 74 years (range 38–94). One patient died before the prevalence date. 78% were previously undiagnosed and untreated. Mean duration of symptoms was 5 years, and median Hoehn and Yahr stage 3. Crude prevalence rates were 30/100,000 (men), 11/100,000 (women) and 20/100,000 (combined). The direct age‐standardized prevalence rates compared with the UK population were 64/100,000 (men), 20/100,000 (women) and 40/100,000 (combined). These rates are higher than previously reported from SSA, but still lower than the developed world. Many PD patients in SSA may never be diagnosed or treated, with consequent reduction in their life expectancy and quality of life. With the world population ageing PD is predicted to become an increasing problem. © 2007 Movement Disorder Society     

EPIDEMIOLOGY of PARKINSON''S DISEASE IN FINLAND

This investigation was conducted to clarify the epidemiology of Parkinson's disease in Finland. A community survey was made in a selected area in southwest Finland in addition to an analysis of Finnish mortality statistics for Parkinson's disease. The annual mortality rate from Parkinson's disease was found to average 2 per 100,000 population. Almost 70 per cent of the deaths occurred between 65-79 years of age. The total and age-specific mortality rates for males were greater than those for females whereas the proportionate mortality rates were almost identical. This was considered to indicate that suggestions of greater male prevalence, based on mortality statistics, do not appear justified. On prevalence day, Dec. 31st, 1971, 484 patients with Parkinson's disease (of which 444 were personally examined) lived in the area of investigation (population 402,988), the prevalence rate being 120.1 per 100,000 population. The highest annual incidence rate was 16.6 per 100,000 population. The age-specific prevalence rates showed a rapid increase after the 50th year of age. The greatest prevalence was shown by the age group 70-79 years of age in which almost 0.8 per cent of the population are affected. Age-specific incidence rates also displayed an increase after the 50th year of age. The greatest incidence was observed in the age group 70-79 years of age in which almost 1 per 1,000 of the population are annually affected by the disease. A difference between the sexes was demonstrable in the prevalence and incidence rates showing greater values for females, but in the age-specific frequencies the differences were reduced. This probably reflects the difference between the age structures of the male and female populations, suggesting that both sexes have a similar risk of being affected by the disease. The permanent age structure shown by idiopathic patients in comparison with previous investigations as well as the increased mean age and proportionate decrease of postencephalitic patients was found to be in disagreement with the cohort theory according to which all parkinsonian patients are previously victims of encephalitis lethargica.     

The prevalence of PD in a nutritionally deficient rural population in China

OBJECTIVES: In most reports, the prevalence of PD in mainland China is lower than in western populations. To estimate PD prevalence in China, we performed a cross-sectional study in a rural population in Linxian County, China. PRIMARY OUTCOMES: Clinical diagnosis of PD. RESULTS: Among the 16,488 participants examined, the overall age- and gender-adjusted prevalence rate of PD was 522/100,000 (95% CI: 477-567) assuming no cases of PD would be found among those younger than 50 years of age. The gender-adjusted prevalence rates were 103 (95% CI: 83-123), 621 (95% CI: 572-670), 902 (95% CI: 843-961), and 1744 (95% CI: 1662-1826) per 100,000 in age groups 50-59, 60-69, 70-79, and 80 and above, respectively. CONCLUSIONS: The estimated prevalence of PD in Linxian, China is higher than most of those reported from other areas in China, and similar to those reported from non-Asian populations.     

The increasing prevalence of Parkinson's disease in Estonia

Objectives

A previous epidemiological study of Parkinson's disease (PD) in the county of Tartu, Estonia, found an adjusted prevalence rate of 152/100 000 persons. We aimed to determine PD prevalence almost 20 years later, as well as evaluate any dynamic changes in disease frequency compared to the first study.

Methods

A cross‐sectional, community‐based study was conducted over 2010‐2016 in the county of Tartu, Estonia. Multiple case‐finding sources, including information from neurologists, family doctors, the local PD Society, nursing institutions, and the database of the Estonian Health Insurance Fund were used to identify patients with PD of all ages.

Results

Total crude PD prevalence was 283 and age‐adjusted prevalence (standardized to the 2014 age structure of the Estonian population) 314/100 000. No significant differences in age‐adjusted prevalence rates were found between men and women, nor people living in urban and rural areas. After adjustment to the same standard population used in the previous prevalence study, the overall age‐adjusted prevalence rate was 197/100 000. Patients in the current study were older and often had a more severe form of PD and a longer disease duration, compared to those reported in the first epidemiological study 20 years ago.

Conclusions

The age‐specific crude rates in oldest age‐groups have risen substantially, and the age‐adjusted prevalence has moderately increased compared to 20 years ago in Estonia. We hypothesize that the increased life expectancy of the Estonian population and improved diagnosis of PD contributed most to the increase in disease frequency.     

Prevalence of chronic inflammatory demyelinating polyneuropathy in New South Wales, Australia

A prevalence study of chronic inflammatory demyelinating polyneuropathy (CIDP) was performed in New South Wales (NSW), Australia, with a prevalence day of August 6, 1996, which coincided with a national census. The population of NSW was 5,995,544, and the crude prevalence of CIDP was 1.9 per 100,000 population. It was higher in male patients than in female patients, and the age-specific prevalence reached a maximum of 6.7 per 100,000 population in the 70- to 79-year-old age group. The prevalence in the city of Newcastle, with a population of 448,663, was 2.0 per 100,000 population and is representative of the whole of NSW. The estimated crude annual incidence was 0.15 per 100,000 population. The mean age of onset was 47.6 years (median, 53.5 years), 51% of patients had a relapsing-remitting course, the mean duration on prevalence day was 7.1 years (median, 5 years), and 87% of patients were able to walk without walking aids or other assistance.     

Ethnic differences in patterns of suicide across the life cycle

OBJECTIVE: The authors analyzed suicide across the life cycle of different ethnic groups in an urban population equally divided between blacks (44.6%) and whites (48.1%). METHOD: Two data sets were used: 1) all suicides in Fulton County, Ga., from January 1994 through December 2002 and 2) all U.S. suicides reported by the National Center for Injury Prevention in 1999 and 2000. RESULTS: The population rates for suicide in Fulton County were 1.22 per 100,000 black females, 10.74 per 100,000 black males, 9.89 per 100,000 white females, and 21.04 per 100,000 white males. In Fulton County, age at completed suicide was more than a decade lower in blacks than in whites. The median age of black victims was 32 years, with an interquartile range (IQR) of 23-45, and the median for whites was 44 years (IQR=31-58); the difference was significant. The mean ages of victims who were black (mean=36.1 years, SD=17.0) and of "other" race (mean=35.7, SD=14.3) were significantly lower than the mean for whites (mean=46.2, SD=18.5). The national data were similar, but minorities accounted for an even smaller percentage of suicides. Median age at completed suicide for African Americans nationally was 34 years (IQR=24-45) compared to 44 years (IQR=32-58) for Caucasians. CONCLUSIONS: African Americans commit suicide at rates much lower than those for whites, but they do so when much younger and they have a narrow, age-defined window of vulnerability. Age-specific psychopathological processes and protective factors may define suicide risk for each demographic group.     

Prevalence of Parkinson's disease in the L'Aquila district, central Italy

OBJECTIVE: We estimated the prevalence of Parkinson's disease (PD) in the L'Aquila district. METHODS: Cases of PD were identified screening all available case sources including general practitioners and antiparkinsonian drug-users by means of pharmacy records. Prevalence of PD was computed considering the prevalence day of December 31, 2001. RESULTS: On the prevalence day, 682 patients with PD were alive and residing in the L'Aquila district. A total of 354 patients were women and 328 men. The overall crude prevalence rate was 229.3/100,000 (95% CI 212.7-247.1), without any difference between men (227.4/100,000; 95% CI 200.0-257.5) and women (231.1/100,000; 95% CI 202.2-263.1). Prevalence rates increased with age in both sexes and were higher in urban (244.5/100,000; 95% CI 213.7-278.5) than in rural residents (214.7/100,000; 95% CI 189.0-242.9) (SRR = 1.7; 95% CI 1.3-2.1). CONCLUSIONS: The prevalence of PD in the L'Aquila district was within the range of prevalence rates found in our country and steeply increased with advancing age in both sexes.     

Epidemiology of dementia in a Finnish population

An epidemiological study of dementia was carried out in the city of Turku (population 164,568) in Finland. A total of 421 patients with moderate to severe dementia were found. Degenerative dementia, i.e. presenile and senile dementia, was present in 218 patients (51.8 %), and in 152 patients (36.1 %) the dementia was associated with arteriosclerosis, including multi-infarct and combined dementia. The prevalence rate of dementia, all types, was 256 per 100,000 population, and 1,961 per 100,000 population over 65 years old. The age-specific prevalence rates of dementia increased with advancing age from 0.1 % in the age group 55–64 years to 11 % in the age group over 85 years. The peak annual incidence rate for all types of dementia was 58 per 100,000 population, and 447 per 100,000 population over 65 years old. Both prevalence and incidence figures suggested a female preponderance in dementia of degenerative origin and in dementia with associated arteriosclerosis.     

Prevalence, incidence, and mortality of PD: a door-to-door survey in Ilan county, Taiwan.

BACKGROUND: The reported prevalence and incidence rates of PD were significantly lower in China than those in Western countries. People in China and Taiwan have a similar ethnic background. OBJECTIVE: To investigate the prevalence, incidence, and mortality rate of PD in Taiwan. METHOD: The authors conducted a population-based survey using a two-stage door-to-door approach for patients aged 40 years or older in Ilan, Taiwan. Patients were diagnosed with PD by having at least two of the four cardinal signs of parkinsonism and exclusion of seconddary parkinsonism. To identify new cases of PD after the survey, patients with negative results of parkinsonism in the first stage were matched to the information on clinical diagnosis of PD from the Bureau of National Health Insurance toward the end of December 31, 1997. All cases of PD were linked to the Taiwan mortality registration to ascertain causes of deaths until December 31, 1999. RESULTS: The participation rate was 88.1% among the 11,411 contacted individuals. Thirty-seven cases of PD were identified. The age-adjusted prevalence rate of PD for all age groups was 130.1 per 100,000 population after being adjusted to the 1970 US census, assuming no cases of PD would be found among those younger than 40 years of age. Of 9972 non-PD subjects in the first screen, 15 new cases of PD were ascertained. The age-adjusted incidence rate was 10.4 per 100,000 population for all age groups. The case fatality rate of PD after a 7-year follow-up was 40.4% (21 deaths in 52 patients with PD). The relative risk of death for PD cases versus non-PD cases was 3.38 (95% CI: 2.05-4.34). The 5-year cumulative survival rate in PD cases (78.85%) was statistically lower than that in non-PD cases (92.84%). CONCLUSION: The prevalence and incidence rates of PD in Taiwan were much higher than those reported in China, but closer to those in Western countries. These results suggest that environmental factors may be more important than racial factors in the pathogenesis of PD.     

Prevalence of neurological disorders in Bangalore, India: a community-based study with a comparison between urban and rural areas

A population-based neuroepidemiological survey of 102,557 individuals in urban and rural Bangalore in Southern India was conducted to determine the prevalence and pattern of neurological disorders. The study population included subjects from urban (51,502) and rural (51,055) areas, identified through a two-stage stratified random sampling method. Trained social workers administered the screening questionnaire, which had been tested and validated in an earlier pilot study and a neurologist examined the individuals who screened positive. Adults, children (<15 years) and elderly adults (>60 years) constituted 61, 34 and 5% of the study group, respectively. There was a distinct difference in education, occupation and income levels between urban and rural areas with all these parameters being lower in the rural population. In the surveyed population, 3,206 individuals with neurological disorders were detected resulting in crude and age-adjusted prevalence rates of 3,126 and 3,355 per 100,000 population, respectively. The prevalence rate among children, middle-aged (31-40 years) and elderly adults was 2,653, 3,932 and 5,012 per 100,000 population, respectively. The prevalence of neurological disorders among women (3,617) was higher compared with men (2,657). The prevalence rate in urban and rural populations was 2,190 and 4,070/1,00,000, respectively, implying that neurological disorders were twice as frequent in rural areas as in urban areas. The prevalence rates per 100,000 population of the most frequent disorders in the descending order of frequency were: headache (1,119), epilepsy (883), febrile convulsions (330), cerebrovascular disorder (150), and mental retardation (142). This large-scale population-based survey provides data that will be crucial for developing hospital and community-based neurological services in India and other developing countries.     

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 of multiple sclerosis among First Nations people in Alberta, Canada

Multiple sclerosis (MS) is thought to be rare among North American aboriginals, although few population-based frequency studies have been conducted. Data from government health databases were used to describe the incidence of MS among First Nations aboriginal people in the province of Alberta compared to the general population from 1994 to 2002. The general population rates were consistently higher than First Nations rates, but were essentially stable across this time span for both groups. For First Nations the MS incidence was 7.6 per 100,000 and 20.6 per 100,000 for the general population in 2002. During 2000-2002 for First Nations the incidence was 12.7 for females and 7.6 for males, with a female-to-male ratio of 1.7:1. During the same period the general population incidence was 32.2 for females and 12.7 for males, with a female-to-male ratio of 2.5:1. The peak incidence for both First Nations and the general population of Alberta was in the age group 30-39 years in 2002. The high incidence rates are consistent with high prevalence rates reported for both groups in 2002: 99.9 per 100,000 for First Nations and 335.0 per 100,000 for the general population. While the MS incidence in First Nations people is lower than in the general population of Alberta, it is not rare by worldwide standards.     

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.     

Age-, gender-, and socioeconomic status-specific incidence of Parkinson's disease and parkinsonism in North East Scotland: The PINE study

There have been few high quality incidence studies of Parkinson's disease (PD). We measured age-, gender- and socioeconomic-specific incidence rates for parkinsonism and PD in north-east Scotland, and compared our results with those of previous high quality studies.Incident patients were identified prospectively over three years by several overlapping methods from primary care practices (total population 311,357). Parkinsonism was diagnosed if patients had two or more cardinal motor signs. Drug-induced parkinsonism was excluded. Patients had yearly follow-up to improve diagnostic accuracy.Incidence rates using clinical diagnosis at latest follow-up were calculated for all parkinsonism and for PD by age, gender and socioeconomic status. Meta-analysis with similar studies was performed.Of 377 patients identified at baseline with possible or probable parkinsonism, 363 were confirmed as incident patients after median follow-up of 26 months (mean age 74.8 years, SD 9.8; 61% men). The crude annual incidence of parkinsonism was 28.7 per 100,000 (95% confidence interval (CI) 25.7–31.8) and PD 17.9 per 100,000 (95% CI 15.5–20.4). PD was more common in men (age-adjusted male to female ratio 1.87:1, 95% CI 1.55–2.23) but there was no difference by socioeconomic status. Meta-analysis of 12 studies showed an incidence of PD (adjusted to the 1990 Scottish population) of 14.6 per 100,000 (95% CI 12.2–17.3) with considerable heterogeneity (I² 95%), partially explained by population size and recruitment duration.The incidence of PD was similar to other high quality studies. The incidence of PD was not affected by socioeconomic status.     

A population-based investigation of Parkinson's disease with and without dementia. Relationship to age and gender.

Because the prevalence of idiopathic Parkinson's disease (PD) with or without dementia remains controversial, we initiated a population-based investigation in the Washington Heights-Inwood section of New York, NY, so that nearly complete case ascertainment could be achieved. A "registry" was developed for the study, and we advertised in periodicals and on radio and television. Subjects, or their records, were examined by experienced neurologists, and most underwent a battery of neuropsychological tests specifically designed for assessment in this community. All data were reviewed by a team of clinicians to achieve a consensus diagnosis. The crude prevalence of idiopathic PD, with and without dementia, was 99.4 per 100,000, increasing from 2.3 per 100,000 for those younger than 50 years to 1144.9 per 100,000 for those aged 80 years and older. The crude prevalence for PD with dementia alone was 41.1 per 100,000 and also increased with age from zero for those younger than 50 years to 787.1 per 100,000 for those aged 80 years and older. Prevalence ratios were comparable with those of other published population-based studies in similar settings. After standardization, men had PD with and without dementia more frequently than did women. The major difference between patients with and without dementia was a later estimated age at onset of motor manifestations. We conclude that PD is a frequent disorder in the elderly population that affects men and whites more frequently than women and nonwhites. Moreover, dementia in patients with PD is more frequent than previously recognized and is strongly related to the age at onset of motor manifestations.     

Epidemiologic survey of multiple sclerosis in the Bucharest city and suburban area

Epidemiologic survey over a restricted area of Romanian territory, i.e. the city of Bucharest with a population of 1,934,052 and a surface of 605 km², established the following values for the MS parameters studied.
On January 5, 1977 the prevalence rate for "probable" and "possible" cases was 46.4 per 100,000 inhabitants and for "probable" cases alone (with certain clinical diagnosis) 41.3 per 100,000.
The specific 20- to 60-year age adjusted prevalence rate was 79.4 per 100,000. The incidence rate over the 1969–1976 period was 1.78 per 100,000.
The prevalence and incidence rates in this survey are similar to those reported for two other large urban centers of Romania (population over 100,000 each), Romania being therefore situated in a geographical area of "high risk" for MS.
The 0.61 per 100,000 nationwide and the 0.65 per 100,000 Bucharest mortality rates are lower than those reported in other geographical areas of "high risk" for MS.     

Prevalence rate of cerebrovascular disease in the rural population of northwest Peloponnese, Greece. A direct epidemiological study

In a direct (door-to-door) epidemiological study, the prevalence rate of cerebrovascular disease in the rural population of northwest Peloponnese, Greece, was found to be 995 strokes per 100,000 inhabitants over 20 years of age. This number is considerably lower than the prevalence rate (1,417 strokes per 100,000 inhabitants over 20 years of age) found in the urban population of the same county (Patras, Greece).     

The prevalence and incidence of Parkinson’s disease in China: a systematic review and meta-analysis

Parkinson’s disease (PD) is a chronic neurodegenerative disorder affecting older individuals. There is inconsistent evidence about the prevalence and incidence of PD in China at present. The aim of the meta-analysis was to estimate the prevalence and incidence of PD and its relation to age, gender, and stage in China. The literature search was conducted using PubMed, EMBASE, Chinese Biological Medical Literature database (CBM), Chinese National Knowledge Infrastructure database (CNKI), Chinese Wanfang and Chongqing VIP database for studies investigating the prevalence and incidence of PD in China from the commencement of the database until August 2012; both English and Chinese publications were included. We estimated the prevalence and incidence of PD using meta-analysis. Thirteen eligible articles were collected. The results showed that the pooled prevalence and incidence of PD were 2 per 100,000 population and 797 per 100,000 person-years. A higher prevalence of PD was found in males than in females (OR 1.29, 95 % CI 1.05–1.57). The prevalence of PD increased with age: the highest was 1,663 per 100,000 in those aged 80 and older. The overall prevalence of PD is lower in China than in developed countries, but the incidence is higher than in some developed countries. Overall, the prevalence of PD appears to increase with age and there are sex differences evident in Chinese individuals.