Time trends in the incidence of parkinson disease

Rodolfo Savica, Brandon R. Grossardt, James Howard Bower, J. Eric Ahlskog, Walter A Rocca

Research output: Contribution to journalArticle

66 Citations (Scopus)

Abstract

Importance Changes over time in the incidence of parkinsonism and Parkinson disease (PD) remain uncertain. OBJECTIVE To investigate secular trends (period effects) and birth cohort trends in the incidence of parkinsonism and PD over 30 years in a geographically defined American population. DESIGN, SETTING, AND PARTICIPANTS We used the medical records-linkage system of the Rochester Epidemiology Project to identify incidence cases of PD and other types of parkinsonism in Olmsted County, Minnesota, from 1976 to 2005. All cases were classified by amovement disorder specialist using defined criteria through the review of the complete medical records within the system. The analyses for this study were conducted between May 2015 and January 2016. MAIN OUTCOMES AND MEASURES Incidence rates of parkinsonism and PD over 30 years.We tested for secular trends (period effects) using negative binomial regression models and for birth cohort effects using age-period-cohort models. RESULTS Of 906 patients with parkinsonism, 501 were men, and the median age at onset was 74 years (interquartile range, 66-81 years). Of the 464 patients with PD, 275 were men, and the median age at onset was 73 years (interquartile range, 64-80 years). The overall incidence rates increased significantly over 30 years in men for both parkinsonism (relative risk [RR], 1.17 per decade; 95%CI, 1.03-1.33) and PD (RR, 1.24 per decade; 95%CI, 1.08-1.43). These trends were driven primarily by the older age groups. In particular, for men 70 years or older, incidence rates increased for both parkinsonism (RR, 1.24 per decade; 95%CI, 1.07-1.44) and PD (RR, 1.35 per decade; 95%CI, 1.10-1.65). The secular trends were not significant for women overall or in age strata.We observed an increased risk for both men and women born in the 1920 cohort (1915-1924). However, this birth cohort effect was significant only for PD and only in men. CONCLUSIONS AND REVELANCE Our study suggests that the incidence of parkinsonism and PD may have increased between 1976 and 2005, particularly in men 70 years and older. These trends may be associated with the dramatic changes in smoking behavior that took place in the second half of the 20th century or with other lifestyle or environmental changes. However, the trends could be spurious and need to be confirmed in other populations.

Original languageEnglish (US)
Pages (from-to)981-989
Number of pages9
JournalJAMA Neurology
Volume73
Issue number8
DOIs
StatePublished - Aug 1 2016

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Parkinsonian Disorders
Parkinson Disease
Incidence
Cohort Effect
Parturition
Age of Onset
Medical Record Linkage
Statistical Models
Population
Medical Records
Life Style
Epidemiology
Cohort Studies
Age Groups
Smoking
Outcome Assessment (Health Care)

ASJC Scopus subject areas

  • Clinical Neurology

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Time trends in the incidence of parkinson disease. / Savica, Rodolfo; Grossardt, Brandon R.; Bower, James Howard; Eric Ahlskog, J.; Rocca, Walter A.

In: JAMA Neurology, Vol. 73, No. 8, 01.08.2016, p. 981-989.

Research output: Contribution to journalArticle

Savica, Rodolfo ; Grossardt, Brandon R. ; Bower, James Howard ; Eric Ahlskog, J. ; Rocca, Walter A. / Time trends in the incidence of parkinson disease. In: JAMA Neurology. 2016 ; Vol. 73, No. 8. pp. 981-989.
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N2 - Importance Changes over time in the incidence of parkinsonism and Parkinson disease (PD) remain uncertain. OBJECTIVE To investigate secular trends (period effects) and birth cohort trends in the incidence of parkinsonism and PD over 30 years in a geographically defined American population. DESIGN, SETTING, AND PARTICIPANTS We used the medical records-linkage system of the Rochester Epidemiology Project to identify incidence cases of PD and other types of parkinsonism in Olmsted County, Minnesota, from 1976 to 2005. All cases were classified by amovement disorder specialist using defined criteria through the review of the complete medical records within the system. The analyses for this study were conducted between May 2015 and January 2016. MAIN OUTCOMES AND MEASURES Incidence rates of parkinsonism and PD over 30 years.We tested for secular trends (period effects) using negative binomial regression models and for birth cohort effects using age-period-cohort models. RESULTS Of 906 patients with parkinsonism, 501 were men, and the median age at onset was 74 years (interquartile range, 66-81 years). Of the 464 patients with PD, 275 were men, and the median age at onset was 73 years (interquartile range, 64-80 years). The overall incidence rates increased significantly over 30 years in men for both parkinsonism (relative risk [RR], 1.17 per decade; 95%CI, 1.03-1.33) and PD (RR, 1.24 per decade; 95%CI, 1.08-1.43). These trends were driven primarily by the older age groups. In particular, for men 70 years or older, incidence rates increased for both parkinsonism (RR, 1.24 per decade; 95%CI, 1.07-1.44) and PD (RR, 1.35 per decade; 95%CI, 1.10-1.65). The secular trends were not significant for women overall or in age strata.We observed an increased risk for both men and women born in the 1920 cohort (1915-1924). However, this birth cohort effect was significant only for PD and only in men. CONCLUSIONS AND REVELANCE Our study suggests that the incidence of parkinsonism and PD may have increased between 1976 and 2005, particularly in men 70 years and older. These trends may be associated with the dramatic changes in smoking behavior that took place in the second half of the 20th century or with other lifestyle or environmental changes. However, the trends could be spurious and need to be confirmed in other populations.

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