Incidence of Parkinson disease in North America

Abstract

Parkinson disease (PD) is the second most common age-related neurodegenerative condition diagnosed in North America. We recently demonstrated, using multiple epidemiological data sources, that the prevalence of PD diagnoses was greater than previously reported and currently used for clinical, research, and policy decision-making. Prior PD incidence estimates have varied, for unclear reasons. There is a need for improved estimates of PD incidence, not only for care delivery planning and future policy but also for increasing our understanding of disease risk. The objective of this study was thus to investigate the incidence of Parkinson disease across five epidemiological cohorts in North America in a common year, 2012. The cohorts contained data on 6.7 million person-years of adults ages 45 and older, and 9.3 million person-years of adults ages 65 and older. Our estimates of age-sex-adjusted incidence of PD ranged from 108 to 212 per 100,000 among persons ages 65 and older, and from 47 to 77 per 100,00 among persons ages 45 and older. PD incidence increased with age and was higher among males. We also found persistent spatial clustering of incident PD diagnoses in the U.S. PD incidence estimates varied across our data sources, in part due to case ascertainment and diagnosis methods, but also possibly due to the influence of population factors (prevalence of genetic risk factors or protective markers) and geographic location (exposure to environmental toxins). Understanding the source of these variations will be important for health care policy, research, and care planning.

Fig. 1. Age- and Sex-Specific Incidence Rates of PD.

Age-Specific Incidence Rates per 100 000 Person-years for (panel A) Females and (panel B) Males of: Treated Parkinsonism in the Ontario population (1,974,100 person-years, 2012); Treated Parkinsonism in the U.S. Medicare Insured population (6,866,623 person-years, 2012); Treated, Neurologist Reviewed Parkinson Disease in the Kaiser Permanente Northern California (KPNC) Insured Population (322,535 person-years, 2012); Movement Disorders Specialist Consensus Parkinson Disease in the Honolulu Asian Aging Study (HAAS) Cohort (138,806 person-years, 2011).

Fig. 2

Geographical variation in 2012 PD Incidence among 6,866,623 Medicare beneficiaries.