Prevalence of Parkinsonism and Parkinson Disease in Urban and Rural Populations from Latin America: A Community Population-Based Survey

Abstract

Background: Age-gender-specific prevalence rates for parkinsonism and Parkinson’s disease (PD) are important to guide research, clinical practice and public health planning; however, prevalence estimates in Latin America (LatAm) are limited. We aimed to estimate the prevalence of parkinsonism and PD and examine its risk factors in a cohort of elderly individuals from LatAm. Methods: Data from 11,613 adults (65+ years) who participated in a baseline assessment of the 10/66 study and who lived in six LatAm countries were analyzed to estimate Parkinsonism and PD prevalence. Crude and age-adjusted prevalence were determined by sex and country. Diagnosis of PD was established using the UK Parkinson’s Disease Society Brain Bank’s clinical criteria. Findings: In this cohort, the prevalence of Parkinsonism was 8.0% (95% CI 7.6%-8.5%), and the prevalence of PD was 2.0% (95% CI 1.7%-2.3%). PD prevalence increased with age from 1.0 to 3.5 (65-69 vs. 80 years or older, p<0.001). Age-adjusted prevalence rates were lower for women than for men. No significant differences were found across countries, except for lower prevalence in urban areas of Peru. PD was positively associated with depression (adjusted prevalence ratio [aPR] 2.06, 95% CI 1.40-3.01, I2=56.0%), dementia (aPR 1.57, 95% CI 1.07- 2.32, I2=0.0%) and educational level (aPR 1.14, 95% CI 1.01- 1.29, I2=58.6%). Interpretation: The reported prevalence of PD in LatAm is similar to the prevalence in HIC. A significant proportion of cases with PD did not have a previous diagnosis, nor did they seek any medical or neurological attention. These findings underscore the need to improve public health programs for populations that are currently undergoing rapid demographic aging and epidemiological transition. Funding: The 10/66 Dementia Research Group’s research has been funded by the Wellcome Trust Health Consequences of Population Change Program (GR066133 – Prevalence phase in Cuba and Brazil; GR080002- Incidence phase in Peru, Mexico, Argentina, Cuba, Dominican Republic, Venezuela, and China). Declaration of Interest: None to declare. Ethical Approval: This project was approved by local institutional review boards and the King’s College London Research Ethics Committee.