Geographic and Ethnic Variation in Parkinson Disease: A Population-Based Study of US Medicare Beneficiaries
Geographic and Ethnic Variation in Parkinson Disease: A Population-Based Study of US Medicare Beneficiaries
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DOI：
10.1159/000275491
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发表时间：
2010-01-01
影响因子：
5.7
通讯作者：
Racette, Brad A.
中科院分区：
文献类型：
--
作者：
Willis, Allison Wright;Evanoff, Bradley A.;Racette, Brad A.
背景：帕金森病是一种常见的神经退行性疾病。帕金森病在美国的种族、性别、年龄和地理分布尚不清楚。方法：我们对1995年和2000-2005年间65岁及以上的美国医疗保险受益人进行了一系列横断面研究。利用每年超过45万例帕金森病病例，我们计算了按种族、年龄、性别和县计算的帕金森病患病率和年发病率。空间分析调查了帕金森病的地理分布。结果：年龄标化的帕金森病患病率(每10万人中)白人为2168.18(+/-95.64)，黑人为1036.41(+/-86.01)，亚洲人为1138.56(+/-46.47)。黑人和白人的发病率比(0.74；95%CI=0.732~0.748)高于患病率(0.58；95%CI=0.575~0.581)，而亚裔发病率比(0.69；95%CI=0.657~0.723)与患病率(0.62；95%CI=0.617~0.631)相似。帕金森病的贝叶斯图谱显示，帕金森病集中在中西部和东北部地区。按四分位数计算的平均县发病率从279到3111，流行率从1175到13800(每10万人)。城市县的患病率和发病率高于农村县(P<；0.01)。聚类分析支持帕金森病发病和流行病例的非随机分布(p<；0.001)。结论：帕金森病在白人中更为常见，在美国中西部和东北部非随机分布。版权所有(C)2010 S.Karger AG，巴塞尔
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. Copyright (C) 2010 S. Karger AG, Basel