Systematic review of the prevalence and incidence of Parkinson's disease in the People's Republic of China.

BackgroundParkinson’s disease (PD) is a common neurodegenerative disorder in older people, and half of the world’s older population lives in Asia. However, the epidemiology of PD in Asian countries is poorly understood. This review assembles evidence on the prevalence and incidence of PD in Asian countries and identifies gaps in our present knowledge.MethodsA systematic search of studies published from 1965 to October 2008 was conducted using MEDLINE and EMBASE. The selection criteria were defined a priori. Prevalence and incidence were standardized to the WHO World Standard Population 2000. Twenty-one original studies were selected for the review. Two studies that described the ethnic origin of participants and contained Asian populations were also included in the analysis.ResultsExcluding one study with questionably low prevalence and incidence, the remaining studies reported a standardized all-age prevalence of 51.3 to 176.9 per 100 000 in door-to-door surveys; prevalence in record-based studies ranged from 35.8 to 68.3 per 100 000. The standardized incidence rates were 8.7 per 100 000 person-years in door-to-door surveys and 6.7 to 8.3 per 100 000 person-years in record-based surveys.ConclusionsThe prevalence of PD in Asian countries was slightly lower than that in Western countries. However, comparison of incidence was difficult because of the small number of studies. Varying methodologies, diagnostic criteria, and case-finding strategies contributed to the considerable variation in the reported prevalence and incidence of PD.

Parkinson's disease (PD) is a rapidly growing neurodegenerative disorder, but up-to-date epidemiological data are lacking in Latin America. We sought to estimate the prevalence and incidence of PD and parkinsonism in Latin America. We searched Medline, Embase, Scopus, Web of Science, Scientific Electronic Library Online, and Literatura Latino-Americana e do Caribe em Ciências da Saúde or the Latin American and Caribbean Health Science Literature databases for epidemiological studies reporting the prevalence or incidence of PD or parkinsonism in Latin America from their inception to 2022. Quality of studies was assessed using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Data were pooled via random-effects meta-analysis and analyzed by data source (cohort studies or administrative databases), sex, and age group. Significant differences between groups were determined by meta-regression. Eighteen studies from 13 Latin American countries were included in the review. Meta-analyses of 17 studies (nearly 4 million participants) found a prevalence of 472 (95% CI, 271-820) per 100,000 and three studies an incidence of 31 (95% CI, 23-40) per 100,000 person-years for PD; and seven studies found a prevalence of 4300 (95% CI, 1863-9613) per 100,000 for parkinsonism. The prevalence of PD differed by data source (cohort studies, 733 [95% CI, 427-1255] vs. administrative databases. 114 [95% CI, 63-209] per 100,000, P < 0.01), age group (P < 0.01), but not sex (P = 0.73). PD prevalence in ≥60 years also differed significantly by data source (cohort studies. 1229 [95% CI, 741-2032] vs. administrative databases, 593 [95% CI, 480-733] per 100,000, P < 0.01). Similar patterns were observed for parkinsonism. The overall prevalence and incidence of PD in Latin America were estimated. PD prevalence differed significantly by the data source and age, but not sex. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

SummaryObjectivesParkinson’s disease (PD) has become a public health concern with global ageing. With a focus on PD, this study sought to project its burden and trends at the national, regional and worldwide levels between 1990 and 2021.Study designPopulation-based study.MethodsThe Global Burden of Disease (GBD) 2021 provided the PD burden data. The GBD data are considered globally and regionally representative, as it integrates multiple data sources and employs standardised estimation methods. The age-standardised rate (ASR) and estimated annual percentage change (EAPC) were used to estimate trends in the incidence, prevalence, mortality and disability-adjusted life years (DALYs) of PD from 1990 to 2021. ASR was used to calculate the EAPCs using a linear regression model. A Bayesian age-period-cohort model was used to predict future trends up to 2046.ResultsGlobally, the overall ASR of PD incidence, prevalence, DALYs and mortality increased from 1990 to 2021. The EAPCs were 1.09 (95% CI: 1.07 to 1.11) for incidence, 1.52 (95% CI: 1.49 to 1.54) for prevalence, 0.32 (95% CI: 0.28 to 0.36) for DALYs and 0.18 (95% CI: 0.13 to 0.23) for mortality. The incidence, prevalence, mortality and DALYs of PD in 2021 were higher in men than in women. The age-standardized incidence rate (ASIR) was 18.52 per 100 000 in men and 12.92 per 100 000 in women (EAPC: 1.11, 95% CI: 1.09 to 1.13 vs 1.07, 95% CI: 1.05 to 1.09). The age-standardized prevalence rate (ASPR) was 157.42 per 100 000 in men and 121.84 per 100 000 in women (EAPC: 1.70, 95% CI: 1.67 to 1.73 vs 1.25, 95% CI: 1.22 to 1.27). The ASMR was 6.57 per 100 000 in men and 3.59 per 100 000 in women (EAPC: 0.21, 95% CI: 0.14 to 0.28 vs −0.01, 95% CI: −0.04 to 0.03). The ASDR was 97.12 per 100 000 in men and 81.23 per 100 000 in women (EAPC: 0.37, 95% CI: 0.33 to 0.42 vs 0.14, 95% CI: 0.10 to 0.18). From 1990 to 2021, the burden of PD remained consistently higher in men than in women, with the gender difference widening with age. The prevalence, incidence, DALYs and mortality rates of PD increased with age before declining, peaking in the 80–84 age group for prevalence and incidence, while peaking in the 90–94 age group for mortality. DALY rates peaked in the 85–89 age group. The ASR of incidence and prevalence increased significantly in Norway (EAPC=3.39, 95% CI: 3.15 to 3.64; EAPC=5.04, 95% CI: 4.65 to 5.43). Lesotho was the nation with the highest rise in age-standardised DALYs for PD (EAPC=1.67, 95% CI: 1.41 to 1.93). The United Arab Emirates had the fastest increase in age-standardised mortality for PD (EAPC=1.98, 95% CI: 1.24 to 2.71). The global ASPR of PD is projected to show a continuous upward trend.ConclusionsFrom 1990 to 2021, there were rising trends in the prevalence and burden of PD in most areas and nations worldwide. Our research indicates that the management and control of PD need significant improvement, particularly in light of the ageing population.

The reported prevalence and incidence rates of PD were significantly lower in China than those in Western countries. People in China and Taiwan have a similar ethnic background. To investigate the prevalence, incidence, and mortality rate of PD in Taiwan. The authors conducted a population-based survey using a two-stage door-to-door approach for patients aged 40 years or older in Ilan, Taiwan. Patients were diagnosed with PD by having at least two of the four cardinal signs of parkinsonism and exclusion of seconddary parkinsonism. To identify new cases of PD after the survey, patients with negative results of parkinsonism in the first stage were matched to the information on clinical diagnosis of PD from the Bureau of National Health Insurance toward the end of December 31, 1997. All cases of PD were linked to the Taiwan mortality registration to ascertain causes of deaths until December 31, 1999. The participation rate was 88.1% among the 11,411 contacted individuals. Thirty-seven cases of PD were identified. The age-adjusted prevalence rate of PD for all age groups was 130.1 per 100,000 population after being adjusted to the 1970 US census, assuming no cases of PD would be found among those younger than 40 years of age. Of 9972 non-PD subjects in the first screen, 15 new cases of PD were ascertained. The age-adjusted incidence rate was 10.4 per 100,000 population for all age groups. The case fatality rate of PD after a 7-year follow-up was 40.4% (21 deaths in 52 patients with PD). The relative risk of death for PD cases versus non-PD cases was 3.38 (95% CI: 2.05-4.34). The 5-year cumulative survival rate in PD cases (78.85%) was statistically lower than that in non-PD cases (92.84%). The prevalence and incidence rates of PD in Taiwan were much higher than those reported in China, but closer to those in Western countries. These results suggest that environmental factors may be more important than racial factors in the pathogenesis of PD.

BackgroundParkinson’s disease (PD) and drug-induced parkinsonism (DIP) are the major diseases of parkinsonism. To better understand parkinsonism, we aimed to assess the prevalence and incidence of PD and DIP in Korea from 2012 to 2015.MethodsWe used the Health Insurance Review and Assessment Service database, which covers the entire population in Korea. We used claims during 2011–2015 to assess epidemiology of PD and DIP during 2012–2015. Retrospective cross-sectional study design was employed to assess prevalence, whereas retrospective cohort study design was used to determine incidence. Patients with at least one claim with ICD-10 G20 and who received antiparkinsonian drugs for at least 60 days were classified as having PD. We excluded patients with antiparkinsonian drugs that can be used for indications other than PD. Patients with at least one claim with ICD-10 G211 or G251 during the prescription period of drugs that are frequently related with DIP were classified as having DIP. Incident cases had a disease-free period of 1 year before diagnosis. To evaluate the significance of changes in the prevalence or incidence over time, Poisson regression was used to determine p for trend.ResultsThe prevalence of PD increased from 156.9 per 100,000 persons in 2012 to 181.3 per 100,000 persons in 2015 (p for trend< 0.0001). The incidence of PD decreased steadily from 35.4 per 100,000 person-years in 2012 to 33.3 per 100,000 person-years in 2015 (p for trend< 0.0001). The prevalence of DIP increased from 7.3 per 100,000 persons in 2012 to 15.4 per 100,000 persons in 2015 (p for trend< 0.0001) and the incidence of DIP increased from 7.1 per 100,000 person-years in 2012 to 13.9 per 100,000 person-years in 2015 (p for trend< 0.0001).ConclusionsOur study suggests that the incidence of PD has gradually decreased whereas, the incidence of DIP increased from 2012 to 2015. Further studies are warranted to examine possible causes of increased DIP incidence in order to develop management strategy for parkinsonism.

ABSTRACTIntroductionParkinson's disease (PD) is a fast‐growing neurodegenerative disease causing a high burden on national health systems. There is a lack of contemporary, reliable epidemiological data for PD in Germany. The aim of this study was to estimate the incidence and prevalence of PD in Germany for the years 2016–2021.MethodsThis is a secondary data analysis of anonymized health claims data from a subset of German statutory health insurances (SHIs) for the years 2016–2021. Data were then extrapolated to represent the full SHI population.ResultsFrom 2016 to 2021, PD prevalence in the study population increased from 494 to 511 patients per 100,000 (p = 0.0067). Incident patients showed no change overall but notably decreased from 2019 to 2020. In contrast, PD prevalence in the extrapolated cohort declined significantly during the same period, dropping from 575 to 501 patients per 100,000 (p < 0.0001). Similarly, PD incidence decreased from 69 to 60 patients per 100,000 (p = 0.0001).ConclusionsPD prevalence increased in the study population but declined in the extrapolated cohort, while incidence remained stable overall in the study population, yet decreased in the extrapolated cohort. This study provides key insights into the epidemiology of PD in Germany, highlighting the influence of methodology and the need for ongoing monitoring to inform healthcare planning.

ObjectivePrimary dysmenorrhea (PD), or painful menstruation, is a common gynecological condition that can cause intense pain and functional disability in women of reproductive age. As a nonmalignant condition, PD is relatively understudied and poorly managed. The purpose of this study was to estimate the prevalence and impact of PD among third-level students in Ireland.DesignA cross-sectional observational design was used.MethodsStudents (n = 892; age range = 18–45 years) completed an online survey on menstrual pain characteristics, pain management strategies, pain interference, and pain catastrophizing.ResultsThe prevalence of PD was 91.5% (95% confidence interval = 89.67–93.33). Nonpharmacological management strategies were most popular (95.1%); of these, heat application (79%), rest (60.4%), hot shower/bath (40.9%), and exercise (25.7%) were most common. Perceived effectiveness of these methods varied between participants. Analgesic use was also common (79.5%); of these, paracetamol was most used (60.5%) despite limited perceived effectiveness. Pain catastrophizing was a significant predictor of variance in both pain intensity and pain interference scores such that those with higher pain catastrophizing scores reported more intense pain and greater interference with daily activities and academic demands.ConclusionsThis article presents the first investigation into PD among third-level students in Ireland. Poorly managed menstrual pain may impact functional ability across several domains. Future research should focus on improving menstrual pain management education and support and promoting menstrual health literacy for women affected by PD.

Limited population-based information is available on the co-occurrence of dementia and PD. However, projecting the prevalence of PD with and without dementia during the next 50 years is crucial for planning public-health and patient-care initiatives. The objective of this study was to project the prevalence of PD with and without dementia in the United States by 2060. We used the Rochester Epidemiology Project medical records-linkage system to identify all persons with PD with or without dementia residing in Olmsted County, Minnesota, on January 1, 2006. A movement disorders specialist reviewed the complete medical records of each person to confirm the presence of PD. We calculated the age- and sex-specific prevalence of PD with and without dementia and projected U.S. prevalence through 2060. We identified 296 persons with PD with and without dementia on the prevalence date (187 men, 109 women); the overall prevalence increased with age from 0.01% (30-39 years) to 2.83% (≥90 years). The prevalence of PD without dementia increased with age from 0.01% (30-39 years) to 1.25% (≥90 years). The prevalence of PD with dementia increased with age from 0.10% (60-69 years) to 1.59% (≥90 years). The prevalence was higher in men than in women for all subtypes and all age groups. We project by 2060 an approximate doubling of the number of persons with PD without dementia and a tripling of the number of persons with PD with dementia in the United States. The prevalence of PD with and without dementia increases with age and is higher in men than women. We project that the number of persons with PD in the United States will increase substantially by 2060. © 2018 International Parkinson and Movement Disorder Society.

Influence of race on healthcare disparities Understanding the relationship between race and health is complex. First, many researchers question the genetic basis of race [9,10]. There is more genetic variation among individuals of the same race than between races; therefore, it is less likely that observed racial differences are due to genetic differences. In addition, the independent inf luence of race on observed healthcare disparities remains controversial. Race may serve as a proxy for education, socioeconomic status, culture or behavioral differences [11]. Therefore, it is possible that race is more often a risk marker and not a risk factor. Disentangling these influences is essential to truly understand and resolve racial disparities. PD epidemiology & race Studies have described racial differences in the incidence and prevalence of PD [1,2]. However, the exact relationship between race and risk of PD remains unknown. Epidemiological studies of PD demonstrate mixed results. While one study suggested that whites are at an increased risk of PD when compared with African–Americans [12], another study showed the opposite, that is, African–Americans are at increased risk of PD [13]. The reason for these discrepant findings is unclear. Some researchers hypothesize that biological differences may explain the observed racial difference in disease risk [14]. Interestingly, a recent study found that lighter hair color and polymorphisms in the MC1R gene coding for hair color are associated with a higher risk of PD [15]. Although differences in hair pigmentation can reflect differences in race, controlling for race in their analysis did not alter the relationship between hair color and PD risk. Another potential reason for the mixed findings in the relationship between PD risk and race are methodological differences. Sources of bias in epidemiological studies such as measurement bias or differences in

ABSTRACTBackgroundParkinson's disease (PD) affects males more than females. The reasons for the gender differences in PD prevalence remain unclear.ObjectiveThe objective of this systematic review and meta‐analysis was to update the overall male/female prevalence ratios (OPR).MethodsWe updated previous work by searching MEDLINE, SCOPUS, and OVID for articles reporting PD prevalence for both genders between 2011 and 2021. We calculated OPRs and investigated heterogeneity in effect estimates.ResultsWe included 19 new articles and 13 articles from a previously published meta‐analysis. The OPR was 1.18, 95% CI, [1.03, 1.36]. The OPR was lowest in Asia and appeared to be decreasing over time. Study design, national wealth, and participant age did not explain OPR heterogeneity.ConclusionGender differences in PD prevalence may not be as stark as previously thought. Studies are needed to understand the role of other determinants of gender differences in PD prevalence.

Organizational and economic levers to activate the cooperation of the Chinese People's Republic and Ukraine in the sphere of tourism, resorts and hotel management

Multimodal drugs and their future for Alzheimer's and Parkinson's disease

BackgroundPrimary dysmenorrhea (PD) is one of the most common gynecological conditions among young females, which has a significant negative impact on health-related quality of life and productivity. Despite its high prevalence, the evidence is limited regarding the management-seeking practices and its perceived effectiveness among females with PD.MethodsThis is a cross-sectional study conducted among 550 female students in six universities across Lebanon. The prevalence of PD, associated risk factors, and management-seeking practices were assessed using a self-administered questionnaire.ResultsThe prevalence of PD was 80.9%. Most of the females with PD described their menstrual pain as moderate (56%) to severe (34.6%), which significantly affected their daily activities and studying ability (P < 0.001). The major risk factors associated with PD included heavy menstrual flow (adjusted odds ratio [AOR] = 10.28), family history of PD (AOR = 2.52), history of weight loss attempt (AOR = 2.05), and medical specialization (AOR = 1.663). Only 36.9% of females with PD sought formal medical advice. Most dysmenorrheic females (76.4%) received medications for the management of PD, and remarkably none of them took hormonal contraceptives. Drugs commonly used for PD were mefenamic acid (26.2%), ibuprofen (25%), and paracetamol (11.5%), which were administered when the pain started (58.2%). All medications were significantly effective in reducing the pain score (P = 0.001), and most NSAIDs were more potent than paracetamol in managing PD (P = 0.001). However, no significant difference in adverse effects among medications was revealed. Moreover, no superiority of any individual NSAID for pain relief was established. Nevertheless, mefenamic acid was associated with the lowest risk of abdominal pain (OR: 0.03, P = 0.005) and the highest risk of flank pain (OR = 12, P = 0.02).ConclusionsSuboptimal management of PD is practiced among university students in Lebanon. Therefore, health care providers should educate dysmenorrheic females to optimize the self-management support of PD. Furthermore, future research is required to investigate females’ misconceptions about hormonal contraceptives in the management of PD, aiming to raise awareness and correct misconceptions.

Based on the promising results from preclinical studies, bee venom has been investigated as a neuroprotective agent in Parkinson's disease. To assess if longstanding exposure to bee venom is associated with decreased risk for Parkinson's disease among beekeepers. Questionnaire gathering information about diagnosis of Parkinson's disease and exposure to bee stings was posted to 6500 members of Slovenian beekeepers' organisation. We received 1298 responses (response rate 20.1%). Twenty beekeepers, all older than 60 years, were diagnosed with Parkinson's disease. The prevalence of Parkinson's disease in beekeepers aged ≥60 years was 3.9%, which is above the reported 0.6-1.3% prevalence of PD in this age group in European population. There was no difference in parameters reflecting bee venom exposure between beekeepers with and without Parkinson's disease. Continuous exposure to bee venom does not affect neurodegeneration to the extent where it could prevent the expression of Parkinson's disease. © 2021 International Parkinson and Movement Disorder Society.

P32. Prevalence of parkinson symptoms among patients with peripheral vestibular disorders