Epidemiology of Parkinson's Disease: A Population-Based Study in Primary Care in Italy

2016 ◽  
Vol 47 (1) ◽  
pp. 38-45 ◽  
Author(s):  
Elisabetta Pupillo ◽  
Claudio Cricelli ◽  
Francesco Mazzoleni ◽  
Iacopo Cricelli ◽  
Alessandro Pasqua ◽  
...  

Background: There are no studies on prevalence, incidence and comorbidities of Parkinson's disease (PD) in the Italian population. Methods: The database of 700 Italian general practitioners (population, 923,356) was investigated. All patients with International Classification of Diseases Ninth Revision - Clinical Modification (ICD-9-CM) diagnosis of PD during the period 2002-2012 were included. Parkinsonisms were excluded. Clinical conditions preceding PD were identified through ICD-9-CM codes. The Charlson Comorbidity Index was used. PD crude and standardized prevalence and annual incidence were calculated. Crude and adjusted hazard ratios were calculated for comorbidities. Results: A total of 2,204 patients (1,140 men, 1,064 women, age 22-95 years) were included. The crude prevalence of PD was 239/100,000. Prevalence increased exponentially with age. Standardized prevalence was 233 (95% CI 232-235). One hundred ninety-four patients were newly diagnosed, giving a crude incidence of 22/100,000 and a standardized incidence of 23.1/100,000 (95% CI 22.9-23.2). Incidence increased steadily until age 75-84 years and then decreased. Older age, cardiovascular and gastrointestinal disorders, diabetes, and restless-legs syndrome were associated with increased PD risk and smoking and hypersomnia with decreased PD risk. The Charlson Comorbidity Index was associated with PD risk with a documented gradient. Conclusions: Prevalence and incidence of PD in Italy are in line with studies with the highest case ascertainment. PD risk varies with the number and type of comorbidities.

Medicina ◽  
2021 ◽  
Vol 57 (12) ◽  
pp. 1292
Author(s):  
Ji Hyoun Kim ◽  
In Ah Choi ◽  
Aryun Kim ◽  
Gilwon Kang

Background and Objectives: This retrospective cohort study aimed to investigate the association between gout and Parkinson’s disease (PD) in Korea. Materials and Methods: Overall, 327,160 patients with gout and 327,160 age- and sex-matched controls were selected from the Korean National Health Insurance Service (NHIS) database. PD incidence was evaluated by reviewing NHIS records during the period from 2002 to 2019. Patients with a diagnosis of gout (International Classification of Diseases-10 (ICD-10), M10) who were prescribed medications for gout, including colchicine, allopurinol, febuxostat, and benzbromarone for at least 90 days were selected. Patients with PD who were assigned a diagnosis code (ICD-G20) and were registered in the rare incurable diseases (RID) system were extracted. Results: During follow-up, 912 patients with gout and 929 control participants developed PD. The incidence rate (IR) of overall PD (per 1000 person-years) was not significantly different between both groups (0.35 vs. 0.36 in gout and control groups, respectively). The incidence rate ratio (IRR) was 0.98 (95% CI: 0.89–1.07). The cumulative incidence of PD was not significantly different between the groups. No association between gout and PD was identified in univariate analysis (HR = 1.00, 95% CI: 0.91–1.10, p = 0.935). HR increased significantly with old age (HR = 92.08, 198, and 235.2 for 60–69 years, 70–79 years, and over 80 years, respectively), female sex (HR = 1.21, 95% CI: 1.07–1.37, p = 0.002), stroke (HR = 1.95, 95% CI: 1.76–2.16, p < 0.001), and hypertension (HR = 1.16, 95% CI: 1.01–1.34, p = 0.04). Dyslipidemia exhibited an inverse result for PD (HR = 0.6, 95% CI: 0.52–0.68, p < 0.001). Conclusions: This population-based study did not identify an association between gout and PD. Age, female sex, stroke, and hypertension were identified as independent risk factors for PD, and dyslipidemia demonstrated an inverse result for PD.


Author(s):  
Santiago R. Unda ◽  
Aldana M. Antoniazzi ◽  
David J. Altschul ◽  
Roberta Marongiu

<b><i>Introduction:</i></b> Peripheral and central nervous system inflammation have been linked to the classic symptoms of Parkinson’s disease (PD) and Alzheimer’s disease (AD). However, it remains unclear whether the analysis of routine systemic inflammatory markers could represent a useful prediction tool to identify clinical subtypes in patients with Parkinson’s and Alzheimer’s at higher risk of dementia-associated symptoms, such as behavioral and psychological symptoms of dementia (BPSD). <b><i>Methods:</i></b> We performed a multivariate logistic regression using the 2016 and 2017 National Inpatient Sample with International Classification of Diseases 10th edition codes to assess if pro-inflammatory white blood cells (WBCs) anomalies correlate with dementia and BPSD in patients with these disorders. <b><i>Results:</i></b> We found that leukocytosis was the most common WBC inflammatory marker identified in 3.9% of Alzheimer’s and 3.3% Parkinson’s patients. Leukocytosis was also found to be an independent risk factor for Parkinson’s dementia. Multivariate analysis of both cohorts showed that leukocytosis is significantly decreased in patients with BPSD compared to patients without BPSD. <b><i>Conclusions:</i></b> These results suggest a link between leukocytosis and the pathophysiology of cognitive dysfunction in both PD and AD. A better understanding of the role of systemic neuroinflammation on these devastating neurodegenerative disorders may facilitate the development of cost-effective blood biomarkers for patient’s early diagnosis and more accurate prognosis.


Author(s):  
Wei-Jun Lin ◽  
Tomor Harnod ◽  
Cheng-Li Lin ◽  
Chia-Hung Kao

Aim: Use the National Health Insurance Research Database of Taiwan to determine whether patients with posttraumatic epilepsy (PTE) have an increased risk of mortality. Methods: Patients ≥20 years old ever admitted because of head injury (per International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 850–854 and 959.01) during 2000–2012 were enrolled into a traumatic brain injury (TBI) cohort. The TBI cohort was divided into with PTE (ICD-9-CM code 345) and posttraumatic nonepilepsy (PTN) cohorts. We compared the PTE and PTN cohorts in terms of age, sex, and comorbidities. We calculated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) of all-cause mortality risk in these cohorts. Results: Patients with PTE had a higher incidence rate (IR) of mortality than did patients with TBI alone (IR per 1000 person-years: 71.8 vs. 27.6), with an aHR 2.31 (95% CI = 1.96–2.73). Patients with PTE aged 20–49, 50–64, and ≥65 years had, respectively, 2.78, 4.14, and 2.48 times the mortality risk of the PTN cohort. Patients with any comorbidity and PTE had 2.71 times the mortality risk as patients in the PTN cohort. Furthermore, patients with PTE had 28.2 increased hospital days and 7.85 times as frequent medical visits per year compared with the PTN cohort. Conclusion: Taiwanese patients with PTE had approximately 2 times the mortality risk and an increased medical burden compared to patients with TBI only. Our findings provide crucial information for clinicians and the government to improve TBI outcomes.


2020 ◽  
Vol 8 (3) ◽  
pp. e000390
Author(s):  
Marc P Morissette ◽  
Heather J Prior ◽  
Robert B Tate ◽  
John Wade ◽  
Jeff R S Leiter

ObjectiveTo investigate associations between concussion and the risk of follow-up diagnoses of attention-deficit hyperactivity disorder (ADHD), mood and anxiety disorders (MADs), dementia and Parkinson’s disease.DesignA retrospective population-based cohort study.SettingAdministrative health data for the Province of Manitoba between 1990–1991 and 2014–2015.ParticipantsA total of 47 483 individuals were diagnosed with a concussion using International Classification of Diseases (ICD) codes (ICD-9-CM: 850; ICD-10-CA: S06.0). All concussed subjects were matched with healthy controls at a 3:1 ratio based on age, sex and geographical location. Associations between concussion and conditions of interest diagnosed later in life were assessed using a stratified Cox proportional hazards regression model, with adjustments for socioeconomic status and pre-existing medical conditions.Results28 021 men (mean age ±SD, 25±18 years) and 19 462 women (30±21 years) were included in the concussion group, while 81 871 men (25±18 years) and 57 159 women (30±21 years) were included in the matched control group. Concussion was associated with adjusted hazard ratios of 1.39 (95% CI 1.32 to 1.46, p<0.001) for ADHD, 1.72 (95% CI 1.69 to 1.76; p<0.001) for MADs, 1.72 (95% CI 1.61 to 1.84; p<0.001) for dementia and 1.57 (95% CI 1.41 to 1.75; p<0.001) for Parkinson’s disease.ConclusionConcussion was associated with an increased risk of diagnosis for all four conditions of interest later in life.


2020 ◽  
Vol 10 (1) ◽  
pp. 38
Author(s):  
Kyu Hyang Cho ◽  
Sang Won Kim ◽  
Jong Won Park ◽  
Jun Young Do ◽  
Seok Hui Kang

Background: This study aimed to evaluate the association between sex and clinical outcomes in patients with coronavirus disease (COVID-19) using a population-based dataset. Methods: In this retrospective study, insurance claims data from the Korea database were used. Patients who tested positive for COVID-19 were included in the study. All diseases were defined according to the International Classification of Diseases 10th revision. During follow-up, the clinical outcomes, except mortality, were assessed using the electrical codes from the dataset. The clinical outcomes noted were: hospitalization, the use of inotropics, high flow nasal cannula, conventional oxygen therapy, mechanical ventilation, extracorporeal membrane oxygenation, development of acute kidney injury, cardiac arrest, myocardial infarction, acute heart failure, pulmonary embolism, and disseminated intravascular coagulation after the diagnosis of COVID-19. Results: A total of 7327 patients were included; of these, 2964 patients (40.5%) were men and 4363 patients (59.5%) were women. There were no significant differences in the Charlson comorbidity index score between men and women in the same age group. The incidence of mortality and clinical outcomes was higher among men than among women. The mortality rate was the highest for the populations aged 50–64 or ≥65 years. The subgroup analyses for age, diabetes mellitus, or hypertension showed favorable results for patient survival or clinical outcomes for women compared to men. Conclusion: Our population-based study showed that female patients with COVID-19 were associated with favorable outcomes. Furthermore, the impact of sex was more evident in patients aged 50–64 or ≥65 years.


PLoS ONE ◽  
2021 ◽  
Vol 16 (2) ◽  
pp. e0246342
Author(s):  
Jiří Búřil ◽  
Petra Búřilová ◽  
Andrea Pokorná ◽  
Ingrid Kováčová ◽  
Marek Baláž

Background Parkinson's disease is a progressive neurodegenerative disease which causes health problem that affects more patients in the past few years. To be able to offer appropriate care, epidemiological analyses are crucial at the national level and its comparison with the international situation. Aim The demographic description of reported patients with parkinsonism (including Parkinson's disease and atypical parkinsonian syndromes) according to the International Classification of Diseases (ICD-10) from the national health registries. Methods Retrospective analysis of data available from the National Health Information System–NHIS and the National Registry of Reimbursed Health Services (NRRHS). Analyzed epidemiological data are intending to determine the regional and specific prevalence of Parkinsonism in the Czech Republic. The International Classification of Diseases diagnoses (ICD-10) of G20 (Parkinson’s disease—PD) and G23.1, G23.2, G23.3 (other degenerative disorders of basal ganglia), and G31.8 (another degenerative disease of basal ganglia) from the period of 2012 to 2018 were included into the analysis. Results We identified 78 453 unique patients from national registries in the period 2012 to 2018. Diagnoses of G20, G23.1, G23.2, and G31.8 were registered as the principal diagnoses in 76.6% of all individual patients. Conclusion We have found a growing number of patients coded with ICD-10 of dg. G20, G23.1, G23.2, G23.3, or G31.8 (N = 27 891 in 2012, and N = 30 612 in 2018). We have proven regional differences in the prevalence of Parkinson´s diagnoses. Therefore we assume most likely also differences in the care of patients with PD based on the availability of specialty care centers.


2017 ◽  
Vol 56 (05) ◽  
pp. 401-406 ◽  
Author(s):  
Jesper Lagergren ◽  
Nele Brusselaers

SummaryBackground: Comorbidities may have an important impact on survival, and comorbidity scores are often implemented in studies assessing prognosis. The Charlson Comorbidity index is most widely used, yet several adaptations have been published, all using slightly different conversions of the International Classification of Diseases (ICD) coding.Objective: To evaluate which coding should be used to assess and quantify comorbidity for the Charlson Comorbidity Index for registry-based research, in particular if older ICD versions will be used.Methods: A systematic literature search was used to identify adaptations and modifications of the ICD-coding of the Charlson Comorbidity Index for general purpose in adults, published in English. Back-translation to ICD version 8 and version 9 was conducted by means of the ICD-code converter of Statistics Sweden.Results: In total, 16 studies were identified reporting ICD-adaptations of the Charlson Comorbidity Index. The Royal College of Surgeons in the United Kingdom combined 5 versions into an adapted and updated version which appeared appropriate for research purposes. Their ICD-10 codes were back-translated into ICD-9 and ICD-8 according to their proposed adaptations, and verified with previous versions of the Charlson Comorbidity Index.Conclusion: Many versions of the Charlson Comorbidity Index are used in parallel, so clear reporting of the version, exact ICD- coding and weighting is necessary to obtain transparency and reproducibility in research. Yet, the version of the Royal College of Surgeons is up-to-date and easy-to-use, and therefore an acceptable co-morbidity score to be used in registry-based research especially for surgical patients.


2018 ◽  
Vol 7 (10) ◽  
pp. 366 ◽  
Author(s):  
Tomor Harnod ◽  
Weishan Chen ◽  
Jen-Hung Wang ◽  
Shinn-Zong Lin ◽  
Dah-Ching Ding

Using the National Health Insurance Research Database of Taiwan, we investigated whether undergoing a hysterectomy increases the risk of depression. A total of 7872 patients aged 30–49 years who underwent a hysterectomy from 2000 to 2013 were enrolled as the hysterectomy group. The comparison group was randomly selected from women who had never undergone a hysterectomy and was four times the size of the hysterectomy group. We calculated adjusted hazard ratios and 95% confidence intervals (CIs) for depression [The International Classification of Diseases, Ninth Revision, Clinical Modification (ICD-9-CM) codes 296.2, 296.3, 300.4, 311] in these cohorts after adjusting for age, comorbidities, oophorectomy, and hormone therapy. The overall incidence of depression was 1.02 and 0.66 per 100 person-years in the hysterectomy and comparison cohorts, respectively, yielding an adjusted hazard ratio of 1.35 (95% CI = 1.22–1.50) for depression risk. When we stratified patients by age, comorbidities, oophorectomy, and hormone use, hysterectomy increased the risk of depression. Hysterectomy, oophorectomy, and post-surgery hormone use were associated with an increased risk of depression when they occurred alone, but conferred a greater risk if they were considered jointly. Hysterectomy would be a predisposing factor for increased risk of subsequent depression. Our findings provide vital information for patients, clinicians, and the government for improving the treatment strategy in the future.


2008 ◽  
Vol 42 (4) ◽  
pp. 590-597 ◽  
Author(s):  
Robert Antonio Ramiarina ◽  
Beatriz Luiza Ramiarina ◽  
Renan Moritz V R Almeida ◽  
Wagner Coelho de Albuquerque Pereira

OBJECTIVE: To develop a Charlson-like comorbidity index based on clinical conditions and weights of the original Charlson comorbidity index. METHODS: Clinical conditions and weights were adapted from the International Classification of Diseases, 10th revision and applied to a single hospital admission diagnosis. The study included 3,733 patients over 18 years of age who were admitted to a public general hospital in the city of Rio de Janeiro, southeast Brazil, between Jan 2001 and Jan 2003. The index distribution was analyzed by gender, type of admission, blood transfusion, intensive care unit admission, age and length of hospital stay. Two logistic regression models were developed to predict in-hospital mortality including: a) the aforementioned variables and the risk-adjustment index (full model); and b) the risk-adjustment index and patient's age (reduced model). RESULTS: Of all patients analyzed, 22.3% had risk scores >1, and their mortality rate was 4.5% (66.0% of them had scores >1). Except for gender and type of admission, all variables were retained in the logistic regression. The models including the developed risk index had an area under the receiver operating characteristic curve of 0.86 (full model), and 0.76 (reduced model). Each unit increase in the risk score was associated with nearly 50% increase in the odds of in-hospital death. CONCLUSIONS: The risk index developed was able to effectively discriminate the odds of in-hospital death which can be useful when limited information is available from hospital databases.


2021 ◽  
Vol 13 ◽  
Author(s):  
Hsun Ou ◽  
Wu-Chien Chien ◽  
Chi-Hsiang Chung ◽  
Hsin-An Chang ◽  
Yu-Chen Kao ◽  
...  

Background:Chlamydia pneumoniae (CPn) is a common community-acquired pneumonia. In the literature, CPn infection is demonstrated to exhibit an association with Alzheimer dementia (AD). We executed the present nationwide, population-based research with the goal of probing the association of CPn infection and antibiotic therapy with AD risk.Methods: We conducted a cohort study using a database extracted from Taiwan's National Health Insurance Research Database (NHIRD). All medical conditions for each enrolled individuals were categorized using the International Classification of Diseases, ninth Revision classifications. Hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between CPn pneumonia-associated hospitalizations and AD were estimated using Fine and Gray's survival analysis and adjusted for comorbidities. The effects of the antibiotics on the HRs for AD in the patients with CPn pneumonia-associated hospitalization were also analyzed.Results: Our analyses included 6,628 individuals, including 1,657 CPn-infected patients, as well as 4,971 controls matched by age, index date, and sex (1:3). In this study, patients hospitalized for CPn pneumonia exhibited a significantly higher AD risk (adjusted HR = 1.599, 95% CI = 1.284–1.971, p &lt; 0.001). We also noted an association of macrolide use (≥15 days) and fluoroquinolone use (≥15 days) with decreased AD risk.Conclusions: We determined CPn pneumonia to be associated with a relatively high AD risk. The result in this study confirmed the findings from previous literatures, by using a large, nationwide, population-based database. Appropriate macrolide and fluoroquinolone treatment may attenuate this risk.


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