Change in the incidence of Parkinson\u2019s disease in a large UK primary care database

Olaitan Okunoye,Kate Walters,Louise Marston,Anette Schrag

doi:10.1038/s41531-022-00284-0

Olaitan Okunoye, Kate Walters + Show 2 more

Open Access

https://doi.org/10.1038/s41531-022-00284-0

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Abstract

Parkinson’s disease (PD) has the fastest rising prevalence of all neurodegenerative diseases worldwide. However, it is unclear whether its incidence has increased after accounting for age and changes in diagnostic patterns in the same population. We conducted a cohort study in individuals aged ≥50 years within a large UK primary care database between January 2006 and December 2016. To account for possible changes in diagnostic patterns, we calculated the incidence of PD using four case definitions with different stringency derived from the combination of PD diagnosis, symptoms, and treatment. Using the broadest case definition, the incidence rate (IR) per 100,000 person years at risk (PYAR) was 149 (95% CI 143.3–155.4) in 2006 and 144 (95% CI 136.9–150.7) in 2016. In conclusion, the incidence of PD in the UK remained stable between 2006 and 2016, when accounting for age and diagnostic patterns, suggesting no major change in underlying risk factors for PD during this time period in the UK.

Highlights

Over the last 20 to 30 years, the prevalence of Parkinson’s disease (PD) has increased worldwide[1,2]
The overall crude incidence rate of PD between 2006 and 2016 as defined by the four case definitions was (1) 57 per 100,000 PYAR using PD diagnosis Read codes and at least 2 prescriptions of antiparkinsonian medication; (2) 70 per 100,000 person years at risk (PYAR) using solely PD diagnosis Read codes; (3) 75 per 100,000 PYAR using PD diagnosis OR symptom Read codes; (4) 140 per 100,000 PYAR using PD diagnosis OR symptom Read codes OR at least one prescription of antiparkinsonian medication(broadest case definition) (Table 1 and Supplementary Tables 1 to 3)
Using the broadest case definition, the incidence rate (IR) per 100,000 PYAR was 151.55 for men and 128.67 for women (Incidence rate ratio (IRR): 0.76

Summary

Introduction

Over the last 20 to 30 years, the prevalence of Parkinson’s disease (PD) has increased worldwide[1,2]. This is, at least partly, related to an increase in life expectancy in most countries during this time. Amongst the few prospective incidence studies worldwide, some report an increase[4–6], whereas others show no change[7] or a decrease in incidence of PD over time[8–10]. Some of these studies were limited by sample size[5,9,10] and one prospective study had a short followup time[4]. Rarely has the effect of different case definitions on the incidence of PD been explored[8]

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