Parkinson’s disease and parkinsonism in a longitudinal study: two-fold higher incidence in men. ILSA Working Group. Italian Longitudinal Study on Aging

Italian National Research Council (CNR CSFET-ILSA Study), Florence, Italy.
Neurology (Impact Factor: 8.3). 12/2000; 55(9):1358-63.
Source: PubMed

ABSTRACT To determine the incidence of parkinsonism and PD in the Italian elderly, and to explore the relation with age and gender.
In eight Italian municipalities, a population-based, parkinsonism-free cohort was followed for an average of 3 years. At the end of the follow-up, the cohort survivors were directly contacted (screening and clinical examination). Cohort members who had died were studied using death certificates, clinical records, and information gathered from relatives and general practitioners. Parkinsonism diagnosis and subtyping were made according to specified diagnostic criteria.
The cohort consisted of 4,341 individuals (65 to 84 years of age): 596 died before the examination, 2,863 (76.4% of the survivors) completed the screening procedure, and 882 refused to participate. The authors found 68 incident cases of parkinsonism: 42 PD (62%), 7 drug-induced parkinsonism (10%), 8 parkinsonism in dementia (12%), 8 vascular parkinsonism (12%), and 3 parkinsonism, unspecified (5.8%). Average annual incidence rate (per 100,000 person-years) in the population aged 65 to 84 years, adjusted to the 1992 Italian population, was 529.7 (95% CI, 400.5 to 658.9) for parkinsonism, and 326.3 (95% CI, 224.1 to 427.5) for PD. Incidence rates for both parkinsonism and PD increased with age in both men and women; men had higher rates in every age group. Age-adjusted relative risk in men compared with women was 1.66 (95% CI, 1.02 to 2.70) for parkinsonism and 2.13 (95% CI, 1.11 to 4.11) for PD.
Incidence of parkinsonism and PD increased with age, PD was the most common type of parkinsonism, and men had a risk of developing PD twice that of women.

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Available from: Marzia Baldereschi, Jun 12, 2015
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    • "In one of the two previous studies that looked at the over 65 s, the incidence of vascular parkinsonism reported here is comparable when comparing similar age groups [7]. The second of these studies [8] reported a higher Fig. 1 "
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    ABSTRACT: Introduction There have been few incidence studies of vascular parkinsonism (VP), progressive supranuclear palsy (PSP), and parkinsonian-type multiple system atrophy (MSA-P). We measured the age-, gender- and socioeconomic-specific incidence rates for these conditions in north-east Scotland. Methods Incident non drug-induced parkinsonian patients were identified prospectively over three years by several overlapping methods from a baseline primary care population of 311,357. Parkinsonism was diagnosed if patients had two or more cardinal motor signs. Patients had yearly follow-up to improve diagnostic accuracy. Incidence rates using the diagnosis by established research criteria at latest follow-up were calculated for each condition by age, gender, and socioeconomic status. Results 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 was 3.2 per 100,000 (95% confidence interval (CI) 2.2-4.3) for VP, 1.7 per 100,000 (95% CI 1.0-2.4) for PSP, and 1.4 per 100,000 (95% CI 0.8-2.1) for MSA-P. VP and MSA-P were more common in men (age-adjusted male to female ratios 2.58 (95% CI 1.65-3.83) and 8.65 (95% CI 4.73-14.5) respectively). Incidence did not vary with socioeconomic status. Discussion This is the first community-based, prospective study to report the incidence of vascular parkinsonism and the third to report the incidence of PSP and MSA-P. Further follow-up and comparison with similar studies in different populations will yield valuable prognostic and aetiological information on these conditions.
    Parkinsonism & Related Disorders 08/2014; 20(8). DOI:10.1016/j.parkreldis.2014.04.013 · 4.13 Impact Factor
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    • "After aging, epidemiological studies have revealed the male sex as a prominent risk factor for developing PD at all ages and for all nationalities studied. Reports of male to female ratios for incidence rates vary from 1.37 to 3.7 (Baldereschi et al., 2000; Swerdlow et al., 2001; Van Den Eeden et al., 2003; Wooten et al., 2004; Shulman and Bhat, 2006; Taylor et al., 2007), with a large meta-analysis study suggesting that, in any specific time-frame, twice as many men than women suffer from PD (Elbaz et al., 2002). "
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    ABSTRACT: Parkinson’s disease (PD) displays a greater prevalence and earlier age at onset in men. This review addresses the concept that sex differences in PD are determined, largely, by biological sex differences in the NSDA system which, in turn, arise from hormonal, genetic and environmental influences. Current therapies for PD rely on dopamine replacement strategies to treat symptoms, and there is an urgent, unmet need for disease modifying agents. As a significant degree of neuroprotection against the early stages of clinical or experimental PD is seen, respectively, in human and rodent females compared with males, a better understanding of brain sex dimorphisms in the intact and injured NSDA system will shed light on mechanisms which have the potential to delay, or even halt, the progression of PD. Available evidence suggests that sex-specific, hormone-based therapeutic agents hold particular promise for developing treatments with optimal efficacy in men and women.
    Frontiers in Neuroendocrinology 08/2014; 35(3). DOI:10.1016/j.yfrne.2014.02.002 · 7.58 Impact Factor
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    • "Therefore, quantitative assessment such as the Unified Parkinson's Disease Rating Scale was not performed at both on and off times. Second, PD patients are predominantly men in European countries and the USA [36] [37] [38] [39]. However , several epidemiological studies have shown a female predominance in PD in the Japanese population , including longitudinal studies in Yonago, Japan, between 1980 and 2004 [40] [41]. "
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    ABSTRACT: Background: Serum uric acid (UA) concentration is linked to the risk of progression of Parkinson's disease (PD). Objectives: The aim of this study was to examine the association between serum UA concentration and the occurrence of wearing-off fluctuation (WOF) in Japanese PD patients. Methods: A total of 123 Japanese patients with PD were enrolled in this study. We collected data on demographics, clinical features, medications, and laboratory findings including serum UA concentration, and examined the presence of WOF. The association between serum UA concentration and WOF was assessed using multivariate logistic regression analysis. Results: After adjusting for possible confounders, it was found that the odds ratio (OR) for WOF decreased with increasing quartile of UA (highest quartile vs. lowest quartile, adjusted OR 0.218, 95% confidence interval [CI] 0.053-0.891). This association was significant only in male PD patients, regardless of the use of sex-specific quartiles of UA. Additionally, disease duration (OR 7.80, 95% CI 2.62-23.17) and daily levodopa dosage (OR 4.06, 95% CI 1.45-11.38) were associated with the occurrence of WOF. Conclusions: Our results showed that serum UA concentration was associated with the occurrence of WOF. Serum UA concentration may be a predictive factor for WOF.
    04/2014; 4(3). DOI:10.3233/JPD-140353
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