The Frequency of Idiopathic Parkinson's Disease by Age, Ethnic Group, and Sex in Northern Manhattan, 1988-1993

Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
American Journal of Epidemiology (Impact Factor: 4.98). 11/1995;
Source: OAI

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: 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.
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    ABSTRACT: Abstract Objectives-To assess and compare the prevalence of parkinsonism and Parkinson's disease in five European populations that were surveyed with similar methodology and diagnostic criteria. Methods-Joint analysis of five community surveys-Gironde (France), eight centres in Italy, Rotterdam (The Netherlands), Girona (Spain), and Pamplona (Spain)-in which subjects were screened in person for parkinsonism. Overall, these surveys comprised 14 636 participants aged 65 years or older. Results-The overall prevalence (per 100 population), age adjusted to the 1991 European standard population, was 2-3 for parkinsonism and 1 6 for Parkinson's disease. The overall prevalence of parkinsonism for the age groups 65 to 69, 70 to 74, 75 to 79, 80 to 84, and 85 to 89 years was respectively, 0-9, 1 5, 37, 50, and 5 1. The corresponding age specific figures for Parkinson's disease were 0-6, 1-0, 27, 36, and 3 5. After adjusting for age and sex, the prevalence figures did not differ significantly across studies, except for the French study in which prevalence was lower. Prevalence was similar in men and women. Overall, 24% of the subjects with Parkinson's disease were newly detected through the surveys. Conclusions-Prevalence of both parkinsonism and Parkinson's disease increased with age, without significant differences between men and women. There was no convincing evidence for differences in prevalence across European countries. A substantial proportion of patients with Parkinson's disease went undetected in the general population
    Journal of neurology, neurosurgery, and psychiatry 01/1997; 62(1):10. · 5.58 Impact Factor
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    ABSTRACT: Parkinson's disease (PD) is essentially characterized by the motor symptoms in the form of resting tremor, rigidity and bradykinesia. However, over the years it has been recognized that motor symptoms are just the "tip of the iceberg" of clinical manifestations of PD. Besides motor symptoms, PD characterized by many non-motor symptoms, which include cognitive decline, psychiatric disturbances (depression, psychosis and impulse control), sleep difficulties, autonomic failures (gastrointestinal, cardiovascular, urinary, thermoregulation) and pain syndrome. This review evaluates the various aspects of psychiatric disorders including cognitive decline and sleep disturbances in patients with PD. The prevalence rate of various psychiatric disorders is high in patients with PD. In terms of risk factors, various demographic, clinical and treatment-related variables have been shown to be associated with higher risk of development of psychiatric morbidity. Evidence also suggests that the presence of psychiatric morbidity is associated with poorer outcome. Randomized controlled trials, evaluating the various pharmacological and non-pharmacological treatments for management of psychiatric morbidity in patients with PD are meager. Available evidence suggests that tricyclic antidepressants like desipramine and nortriptyline are efficacious for management of depression. Among the antipsychotics, clozapine is considered to be the best choice for management of psychosis in patients with PD. Among the various cognitive enhancers, evidence suggest efficacy of rivastigmine in management of dementia in patients with PD. To conclude, this review suggests that psychiatric morbidity is highly prevalent in patients with PD. Hence, a multidisciplinary approach must be followed to improve the overall outcome of PD. Further studies are required to evaluate the efficacy of various other measures for management of psychiatric morbidity in patients with PD.
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