Geographic and ethnic variation in Parkinson disease: a population-based study of US Medicare beneficiaries

Document Type

Article

Abstract

BACKGROUND: Parkinson disease is a common neurodegenerative disease. The racial, sex, age, and geographic distributions of Parkinson disease in the US are unknown. METHODS: 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. RESULTS: 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). CONCLUSIONS: Parkinson disease is substantially more common in Whites, and is nonrandomly distributed in the Midwest and Northeastern US.

Medical Subject Headings

Aged; Aged, 80 and over; Cross-Sectional Studies; Ethnicity (ethnology); Female; Humans; Male; Medicare (statistics & numerical data); Parkinson Disease (diagnosis, ethnology, etiology); Population Surveillance (methods); United States (ethnology)

Publication Date

1-1-2010

Publication Title

Neuroepidemiology

E-ISSN

1423-0208

Volume

34

Issue

3

First Page

143

Last Page

51

PubMed ID

20090375

Digital Object Identifier (DOI)

10.1159/000275491

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