Prevalence of parkinsonism and Parkinson disease in urban and rural populations from Latin America: A community based study

Jorge J Llibre-Guerra; Matthew Prina; Ana Luisa Sosa; Daisy Acosta; Ivonne Z Jimenez-Velazquez; Mariella Guerra; Aquiles Salas; Juan C Llibre-Guerra; Adolfo Valvuerdi; Geeske Peeters; Ellen Ziegemeier; Isaac Acosta; Caroline Tanner; Jorge Juncos; Juan J Llibre Rodriguez

doi:10.1016/j.lana.2021.100136

Prevalence of parkinsonism and Parkinson disease in urban and rural populations from Latin America: A community based study

Lancet Reg Health Am. 2022 Mar:7:None. doi: 10.1016/j.lana.2021.100136.

Authors

Jorge J Llibre-Guerra^{1

2}, Matthew Prina³, Ana Luisa Sosa⁴, Daisy Acosta⁵, Ivonne Z Jimenez-Velazquez⁶, Mariella Guerra⁷, Aquiles Salas⁸, Juan C Llibre-Guerra⁹, Adolfo Valvuerdi¹⁰, Geeske Peeters¹¹, Ellen Ziegemeier¹, Isaac Acosta⁴, Caroline Tanner¹², Jorge Juncos¹³, Juan J Llibre Rodriguez¹⁴

Affiliations

¹ Department of Neurology, Washington University School of Medicine in St. Louis, USA.
² Department of Neurology, National Institute of Neurology and Neurosurgery, La Habana, Cuba.
³ Health Service and Population Research Department, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, United Kingdom.
⁴ Laboratory of the Dementias, National Institute of Neurology and Neurosurgery of Mexico, National Autonomous University of Mexico, Mexico City, Mexico.
⁵ Universidad Nacional Pedro Henriquez Ureña (UNPHU), Internal Medicine Department, Geriatric Section, Santo Domingo, Dominican Republic.
⁶ Internal Medicine Department, Geriatrics Program, School of Medicine, Medical Sciences Campus, University of Puerto Rico, San Juan, Puerto Rico.
⁷ Instituto de la Memoria Depresion y Enfermedades de Riesgo IMEDER, Lima, Perú.
⁸ Medicine Department, Caracas University Hospital, Faculty of Medicine, Universidad Central de Venezuela, Caracas, Venezuela.
⁹ Department of Neurology, Hospital del Mar, Barcelona, Spain.
¹⁰ Medical University of Matanzas, Matanzas, Cuba.
¹¹ Radboud Institute of Health Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
¹² Department of Neurology, Weill Institute for Neurosciences, University of San Francisco, California, USA.
¹³ Department of Neurology, Emory University School of Medicine.
¹⁴ Facultad de Medicina Finlay-Albarran, Medical University of Havana, Havana, Cuba.

Abstract

Background: Age and gender specific prevalence rates for parkinsonism and Parkinson's disease (PD) are important to guide research, clinical practice, and public health planning; however, prevalence estimates in Latin America (LatAm) are limited. We aimed to estimate the prevalence of parkinsonism and PD and examine related risk factors in a cohort of elderly individuals from Latin America (LatAm).

Methods: Data from 11,613 adults (65+ years) who participated in a baseline assessment of the 10/66 study and lived in six LatAm countries were analyzed to estimate parkinsonism and PD prevalence. Crude and age-adjusted prevalence were determined by sex and country. Diagnosis of PD was established using the UK Parkinson's Disease Society Brain Bank's clinical criteria.

Findings: In this cohort, the prevalence of parkinsonism was 8.0% (95% CI 7.6%-8.5%), and the prevalence of PD was 2.0% (95% CI 1.7%-2.3%). PD prevalence increased with age from 1.0 to 3.5 (65-69vs. 80 years or older, p < 0.001). Age-adjusted prevalence rates were lower for women than for men. No significant differences were found across countries, except for lower prevalence in urban areas of Peru. PD was positively associated with depression (adjusted prevalence ratio [aPR] 2.06, 95% CI 1.40-3.01, I ² = 56.0%), dementia (aPR 1.57, 95% CI 1.07- 2.32, I ² = 0.0%) and educational level (aPR 1.14, 95% CI 1.01- 1.29, I ² = 58.6%).

Interpretation: The reported prevalence of PD in LatAm is similar to reports from high-income countries (HIC). A significant proportion of cases with PD did not have a previous diagnosis, nor did they seek any medical or neurological attention. These findings underscore the need to improve public health programs for populations currently undergoing rapid demographic aging and epidemiological transition.

Funding: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.

Keywords: Latin America; Parkinson's disease; Parkinsonism; Prevalence; Risk factors.

Grants and funding

Wellcome Trust/United Kingdom