Abstract
Estimates of the prevalence of Parkinson’s disease in North America have varied widely and many estimates are based on small numbers of cases and from small regional subpopulations. We sought to estimate the prevalence of Parkinson’s disease in North America by combining data from a multi-study sampling strategy in diverse geographic regions and/or data sources. Five separate cohort studies in California (2), Minnesota (1), Hawaii USA (1), and Ontario, Canada (1) estimated the prevalence of PD from health-care records (3), active ascertainment through facilities, large group, and neurology practices (1), and longitudinal follow-up of a population cohort (1). US Medicare program data provided complementary estimates for the corresponding regions. Using our age- and sex-specific meta-estimates from California, Minnesota, and Ontario and the US population structure from 2010, we estimate the overall prevalence of PD among those aged ≥45 years to be 572 per 100,000 (95% confidence interval 537–614) that there were 680,000 individuals in the US aged ≥45 years with PD in 2010 and that that number will rise to approximately 930,000 in 2020 and 1,238,000 in 2030 based on the US Census Bureau population projections. Regional variations in prevalence were also observed in both the project results and the Medicare-based calculations with which they were compared. The estimates generated by the Hawaiian study were lower across age categories. These estimates can guide health-care planning but should be considered minimum estimates. Some heterogeneity exists that remains to be understood.
Highlights
Prevalence estimates of disease are important for public health planning
Using Kaiser Permanente Northern California Integrated Health Care System (KPNC), Ontario, Rochester Epidemiology Project (REP), and California Parkinson’s disease Registry-Pilot Project (CPDR-PP) data, the combined prevalence for men and women aged >45 years standardized by age and sex to the US population according to the 2010 US census was 572 per 100,000 (95% confidence intervals 537–614)
We calculated the prevalence of parkinsonism as estimated by the Copiah County study7 standardized to the US population (2010) to be 301 per 100,000 (Table 2)
Summary
Prevalence estimates of disease are important for public health planning. The upcoming demographic shifts toward older individuals in western nations have led to major efforts to project the health-care burden over the coming decades, for diseases for which incidence rises considerably with age, such as Alzheimer’s disease and Parkinson’s disease (PD). Point estimates of age-specific prevalence across regions varied widely, and confidence intervals were broad, limiting the interpretability of these data for public health planning. Only two such studies were identified in North America since 1985, both in Canada identifying 2 and 4 PD cases each.. Medical records or health system claims data are used to estimate PD prevalence. The limitations of this approach with respect to diagnostic misclassification notwithstanding, an advantage of such studies is their size, often using data on millions of individuals to deliver more precise estimates than can be produced by studies that contact people directly. North American estimates of PD prevalence from such studies have varied widely and have noted geographical variation.
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