Geographic and Ethnic Variation in Parkinson Disease: A Population-Based Study of US Medicare Beneficiaries

Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO 63110, USA.
Neuroepidemiology (Impact Factor: 2.56). 04/2010; 34(3):143-51. DOI: 10.1159/000275491
Source: PubMed


Parkinson disease is a common neurodegenerative disease. The racial, sex, age, and geographic distributions of Parkinson disease in the US are unknown.
We performed a serial cross-sectional study of US Medicare beneficiaries aged 65 and older from the years 1995, and 2000-2005. Using over 450,000 Parkinson disease cases per year, we calculated Parkinson disease prevalence and annual incidence by race, age, sex, and county. Spatial analysis investigated the geographic distribution of Parkinson disease.
Age-standardized Parkinson disease prevalence (per 100,000) was 2,168.18 (+/-95.64) in White men, but 1,036.41 (+/-86.01) in Blacks, and 1,138.56 (+/-46.47) in Asians. The incidence ratio in Blacks as compared to Whites (0.74; 95% CI = 0.732-0.748) was higher than the prevalence ratio (0.58; 95% CI = 0.575-0.581), whereas the incidence ratio for Asians (0.69; 95% CI = 0.657-0.723) was similar to the prevalence ratio (0.62; 95% CI = 0.617-0.631). Bayesian mapping of Parkinson disease revealed a concentration in the Midwest and Northeast regions. Mean county incidence by quartile ranged from 279 to 3,111, and prevalence from 1,175 to 13,800 (per 100,000). Prevalence and incidence in urban counties were greater than in rural ones (p < 0.01). Cluster analysis supported a nonrandom distribution of both incident and prevalent Parkinson disease cases (p < 0.001).
Parkinson disease is substantially more common in Whites, and is nonrandomly distributed in the Midwest and Northeastern US.

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Available from: Brad A Racette, Oct 07, 2015
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    • "An estimated prevalence and incidence of PD in Israel have been recently assessed using an algorithm based on computerized drug purchase data [2]. A number of studies found PD geographic clustering suggesting a common environmental factor [3] [4]. Exposure to environmental factors such as living in a rural area, well water use, exposure to pesticides, and heavy metals may serve as a risk factor for developing PD [5]. "
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    ABSTRACT: The risk for developing Parkinson’s disease (PD) is a combination of multiple environmental and genetic factors. The Negev (Southern Israel) contains approximately 252.5 km 2 of agricultural cultivated fields (ACF). We aimed to estimate the prevalence and incidence of PD and to examine possible geographical clustering and associations with agricultural exposures. We screened all “Clalit” Health Services members in the Negev (70% of the population) between the years 2000 and 2012. Individual demographic, clinical, and medication prescription data were available. We used a refined medication tracer algorithm to identify PD patients. We used mixed Poisson models to calculate the smoothed standardized incidence rates (SIRs) for each locality. We identified ACF and calculate the size and distance of the fields from each locality. We identified 3,792 cases of PD. SIRs were higher than expected in Jewish rural localities (median SIR [95% CI]: 1.41 [1.28; 1.53] in 2001–2004, 1.62 [1.48; 1.76] in 2005–2008, and 1.57 [1.44; 1.80] in 2009–2012). Highest SIR was observed in localities located in proximity to large ACF (SIR 1.54, 95% CI 1.32; 1.79). In conclusion, in this population based study we found that PD SIRs were higher than expected in rural localities. Furthermore, it appears that proximity to ACF and the field size contribute to PD risk.
    Parkinson's Disease 09/2015; 2015(4):576564. DOI:10.1155/2015/576564 · 2.01 Impact Factor
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    • "Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's disease, affecting 1% of people over the age of 65 and approximately 4% of the population over age 80 (de Rijk et al., 2000; Wright Willis et al., 2010). "
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    ABSTRACT: Parkinson’s disease (PD) is characterized by dopaminergic (DA) neuron depletion. Early detection of PD may help in selecting the appropriate treatment. Biomarkers of PD have been suggested, however none of these is currently in clinical use. The aim of this study was to identify volatile organic compounds (VOCs) as early biomarkers of PD. Our hypothesis was that during PD progression, specific VOCs are generated that are linked to the biochemical pathways characterizing PD. These VOCs can be detected by GC–MS combined with solid-phase microextraction (SPME) technique. Three groups of rats were studied: DA-lesioned rats injected with 6-hydroxydopamine (HDA; 250 μg/rat n=11); control rats injected with saline (n=9), and control rats injected with DSP-4 (n=8), a specific noradrenergic neuron toxin. Blood and striatal tissue homogenate were analyzed. In the blood, 1-octen-3-ol and 2-ethylhexanol were found at significantly higher concentrations in HDA versus sham rats. In the striatal homogenate 1-octen-3-ol and other four compounds were found at significantly lower concentrations in HDA versus sham rats. 1-Octen-3-ol is a cytotoxic compound. These results may lead to the development of an early diagnostic test for PD based on profiling of VOCs in body fluids.
    Neurochemistry International 10/2014; DOI:10.1016/j.neuint.2014.06.016 · 3.09 Impact Factor
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    • "Autonomic dysfunction, cognitive dysfunction, and sleeping and sensory abnormalities, such as hyposmia, paresthesia, and chronic pain (Jankovic 2008), characterize the constellation of nonmotor clinical symptoms. The prevalence of PD is between 1% and 2%, although the actual number of patients with the disease is likely higher as many go undiagnosed or misdiagnosed (Schrag et al. 2002; Wright-Willis et al. 2010). The cause of PD is unknown, though at least one subtype demonstrates a genetic linkage (for a review, see Corti et al. 2011). "
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    ABSTRACT: Parkinson's disease (PD) is a neurodegenerative disorder associated with debilitating motor, posture, and gait abnormalities. Human studies recording local field potentials within the subthalamic nucleus and scalp-based electroencephalography have shown pathological beta synchronization throughout the cortical-basal ganglia motor network in PD. Suppression of such pathological beta synchronization has been associated with improved motor function, which may explain the effectiveness of deep-brain stimulation. We used magnetoencephalography (MEG) to investigate neural population-level beta responses, and other oscillatory activity, during a motor task in unmedicated patients with PD and a matched group of healthy adults. MEG is a noninvasive neurophysiological technique that permits the recording of oscillatory activity during movement planning, execution, and termination phases. Each of these phases was independently examined using beamforming to distinguish the brain areas and movement phases, where pathological oscillations exist during motor control. Patients with PD exhibited significantly diminished beta desynchronization compared with controls prior to and during movement, which paralleled reduced alpha desynchronization. This study is the first to systematically investigate neural oscillatory responses in PD during distinct stages of motor control (e.g. planning, execution, and termination) and indicates that these patients have significant difficulty suppressing cortical beta synchronization during movement planning, which may contribute to their diminished movement capacities.
    Cerebral Cortex 10/2014; 24:2669–2678. DOI:10.1093/cercor/bht121 · 8.67 Impact Factor
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