Time trends in incidence of Parkinson's disease diagnosis in UK primary care
Time trends in incidence of Parkinson's disease diagnosis in UK primary care
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DOI：
10.1007/s00415-012-6804-z
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发表时间：
2013-05-01
影响因子：
6
通讯作者：
Schrag, Anette
中科院分区：
文献类型：
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作者：
Horsfall, Laura;Petersen, Irene;Schrag, Anette
在英国初级保健数据库健康改善网络(Thin)的一个大型人群队列中，检查时间趋势以及社会人口和地理因素对帕金森病(PD)诊断发病率的影响。提取1999年1月至2009年12月期间所有年龄在50岁以上、对THIN有贡献的患者，并根据年龄、性别、时间段、社会剥夺评分和城乡状况确定帕金森病的发病率。50岁以上人群诊断帕金森病的总发病率为每10万人年84例(95%可信区间82-85)。在考虑了社会人口因素后，男性的调整发病率比女性高46%(95%可信区间43-48%)。调整后的发病率在城市地区也比农村地区高12%(95%可信区间4-20%)，在社会贫困程度较低的地区略低。随着时间的推移，帕金森病的诊断呈下降趋势，调整后的发病率在1999至2009年间每年下降约6%(95%可信区间为5-6%)。将帕金森病的定义从诊断代码扩大到包括症状和抗帕金森病药物处方，将总发病率增加到每10万人年118例(95%可信区间116-120)，并随着时间的推移显示出更弱的下降趋势，约为每历年1%(95%可信区间1-2%)。按照更广泛的定义，调整后的发病率在男性高于女性，在城市地区高于农村地区，但在社会贫困地区并不明显。正如预期的那样，初级保健环境中的帕金森病诊断率男性更高，城市地区略高，但社会经济群体之间没有差异。初级保健环境中的帕金森病诊断有所下降，这在很大程度上可能是诊断和/或编码的变化，而不是发病率的真正下降。
To examine time trends and the influence of socio-demographic and geographic factors on incidence of Parkinson's disease (PD) diagnosis in a large UK population-based cohort from The Health Improvement Network (THIN), a UK primary care database. All patients aged over 50 years and contributing data to THIN between January 1999 and December 2009 were extracted and the incidence rates of PD diagnoses were determined by age, gender, time period, social deprivation score and urban/rural status. The overall incidence of PD diagnosis for people over 50 years was 84 per 100,000 person years (95 % CI 82-85). After accounting for socio-demographic factors, the adjusted incidence rates in men were 46 % higher (95 % CI 43-48 %) than in women. Adjusted incidence rates were also 12 % higher in urban than rural areas (95 % CI 4-20 %) and slightly lower in less socially deprived areas. Over time there was a downward trend in PD diagnosis with the adjusted incidence rates declining by around 6 % every calendar year (95 % CI 5-6 %) between 1999 and 2009. Broadening the definition of PD from diagnostic codes to include symptoms and antiparkinsonian drug prescriptions increased the overall incidence to 118 per 100,000 person years (95 % CI 116-120) and showed a much weaker downward trend over time of around 1 % per calendar year (95 % CI 1-2 %). With the broader definition, the adjusted incidence rates remained significantly higher in men compared to women and in urban areas compared with rural areas but not in socially deprived areas. The PD diagnosis rates in the primary care setting were, as expected, higher in men, and slightly higher in urban areas, but not different between socio-economic groups. There was a decline in PD diagnosis in the primary care setting, which may largely represent changes in diagnosis and/or coding rather than a true decline in incidence.