The Frequency of Idiopathic Parkinson's Disease by Age, Ethnic Group, and Sex in Northern Manhattan, 1988-1993
ABSTRACT Sex and ethnic differences in the frequency of Parkinson's disease have become increasingly important, because putative genetic and environmental risk factors have been identified. The authors estimated the prevalence and incidence of Parkinson's disease in a culturally diverse community in New York City over a 4-year period (January 1, 1988–December 31, 1991) using a disease registry substantiated, for older individuals, by a subsequent survey of a random sample of Medicare recipients between January 1, 1992, and December 31, 1993. The prevalence rate was 107 per 100,000 persons, and over a 3-year period the average incidence rate was 13 per 100,000 person-years. Age-adjusted prevalence rates were lower for women than for men in each ethnic group and were lower for blacks than for whites and Hispanics. Incidence rates were highest among black men, but they were otherwise comparable across the sex and ethnic groups. The estimated cumulative incidence of Parkinson's disease up to age 90 years was lower for women than for men, which could partially explain the lower prevalence rate. By ethnic group, the cumulative incidence was higher for blacks than for whites and Hispanics, but more deaths occurred among incident black cases. Discrepant prevalence and incidence rates of Parkinson's disease among blacks and women warrant further investigation. While selective mortality could partially account for this paradox, it is also possible that a delay in diagnosis due to limited access to appropriate health services among these individuals could have resulted in the observed discordant rates of disease.
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ABSTRACT: We have used multiple sources to identify a population-representative cohort of newly diagnosed patients with parkinsonism and Parkinson's disease in the UK over a 2-year period. All patients have been invited to participate in a detailed clinical assessment either at home or in an outpatient clinic. These assessments have been used to refine clinical diagnoses of parkinsonism using established criteria, and describe some of the phenotypic variability of Parkinson's disease at the time of diagnosis. The crude incidence of Parkinson's disease was 13.6/10(5yr-1) [confidence interval (CI) 11.8-15.6 and of parkinsonism was 20.9/10(5yr-1) (CI 18.7-23.3). Age-standardized to the 1991 European population, the incidence figures become 10.8/10(5yr-1) (CI 9.4-12.4) for Parkinson's disease and 16.6/10(5yr-1) (CI 14.8-18.6) for parkinsonism. Thirty-six per cent of the Parkinson's disease patients had evidence of cognitive impairment based on their performance in the Mini-Mental State Examination, a pattern recognition task, and the Tower of London task. The pattern of cognitive deficits seen among these patients using these and further cognitive tasks suggests that sub-groups of patients based on cognitive ability might be identifiable even in the early stages of disease, which may reflect regional differences in the underlying neuropathological processes.Brain 04/2004; 127(Pt 3):550-60. DOI:10.1093/brain/awh067 · 10.23 Impact Factor
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ABSTRACT: ABSTRACT Parkinson’s disease (PD) is the first common cause of parkinsonism and it is the second most common neurodegenerative disorder after Alzheimer’s disease. The cardinal signs of the disease are rigidity, tremor , hypokinesia, and postural instability, usually asymmetric and good response to dopaminergic therapy Patients and methods. A descriptive longitudinal, prospective cohort study included consecutive outpatients diagnosed as PD since July 2008 at July 2010 at the Instituto Nacional de Ciencias Neurológicas. A semistructured chart was applied. Results. Four hundred fulfilled the diagnostic criteria. Slight male predominance was evidenced (M:F = 1,5:1). The mean age of disease was 63,6 years. The mean age of onset of motor symptoms was 57.9 years. The mean disease duration at diagnosis was 6 years. The initial symptom is tremor in 290 patients (72,3%), hypokinesia 61 (15,2%) and rigidity 50 (12,5%), all initiated asymmetrically. The upper limb was first affected in 349 patients (87,3%). 276 patients (69%) presented with unilateral motor symptoms, and the development of bilateral motor signs was 3 years. Conclusions. The clinical characteristics of PD in Peru are presented. Our study revealed a predominance of male sex similar to other studies; the mean age is within the range reported by the literature, mostly right handed, The upper limb was first affected, the patients presented with unilateral motor symptoms, and the development of bilateral motor signs was 3 years, The cardinal features of Parkinson’s disease are hypokinesia, rigidity, tremor. Key words. Hypokinesia, Parkinsonism, Parkinson’s disease, Rigidity, Tremor.