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Zhu J, Cui Y, Zhang J, Yan R, Su D, Zhao D, Wang A, Feng T. Temporal trends in the prevalence of Parkinson's disease from 1980 to 2023: a systematic review and meta-analysis. THE LANCET. HEALTHY LONGEVITY 2024; 5:e464-e479. [PMID: 38945129 DOI: 10.1016/s2666-7568(24)00094-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2024] [Revised: 05/10/2024] [Accepted: 05/13/2024] [Indexed: 07/02/2024] Open
Abstract
BACKGROUND Parkinson's disease is the second most common neurodegenerative disorder, exhibiting an upward trend in prevalence. We aimed to investigate the prevalence of Parkinson's disease, temporal trends between 1980 and 2023, and variations in prevalence by location, age, sex, survey period, sociodemographic index (SDI), human development index (HDI), and study characteristics (sample size, diagnostic criteria, and data source). METHODS In this systematic review and meta-analysis we searched PubMed, Cochrane, Web of Science, Embase, Scopus, and Global Health for observational studies that reported Parkinson's disease prevalence in the general population from database inception to Nov 1, 2023. We included studies if they were original observational investigations, had participants from the general population or community-based datasets, and provided numerical data on the prevalence of Parkinson's disease either with 95% CIs or with sufficient information to calculate 95% CIs. Studies were excluded if they were conducted in a specific population, had a sample size smaller than 1000, or were review articles, case reports, protocols, meeting abstracts, letters, comments, short communications, posters, and reports. The publication characteristics (first author and publication year), study location (countries, WHO regions, SDI, and HDI), survey period, study design, diagnostic criteria, data source, participant information, and prevalence data were extracted from articles using a standard form. Two authors independently evaluated eligibility, and discrepancies were resolved through discussion with the third author. We used random effect models to pool estimates with 95% CIs. Estimated annual percentage change (EAPC) was calculated to assess the temporal trend in prevalence of Parkinson's disease. The study was registered with PROSPERO, CRD42022364417. FINDINGS 83 studies from 37 countries were eligible for analysis, with 56 studies providing all-age prevalence, 53 studies reporting age-specific prevalence, and 26 studies providing both all-age and age-specific prevalence. Global pooled prevalence of Parkinson's disease was 1·51 cases per 1000 (95% CI 1·19-1·88), which was higher in males (1·54 cases per 1000 [1·17-1·96]) than in females (1·49 cases per 1000 [1·12-1·92], p=0·030). During different survey periods, the prevalence of Parkinson's disease was 0·90 cases per 1000 (0·48-1·44; 1980-89), 1·38 cases per 1000 (1·17-1·61; 1990-99), 1·18 cases per 1000 (0·77-1·67; 2000-09), and 3·81 cases per 1000 (2·67-5·14; 2010-23). The EAPC of Parkinson's disease prevalence was significantly higher in the period of 2004-23 (EAPC 16·32% [95% CI 6·07-26·58], p=0·0040) than in the period of 1980-2003 (5·30% [0·82-9·79], p=0·022). Statistically significant disparities in prevalence were observed across six WHO regions. Prevalence increased with HDI or SDI. Considerable variations were observed in the pooled prevalence of Parkinson's disease based on different sample sizes or diagnostic criteria. Prevalence also increased with age, reaching 9·34 cases per 1000 (7·26-11·67) among individuals older than 60 years. INTERPRETATION The global prevalence of Parkinson's disease has been increasing since the 1980s, with a more pronounced rise in the past two decades. The prevalence of Parkinson's disease is higher in countries with higher HDI or SDI. It is necessary to conduct more high-quality epidemiological studies on Parkinson's disease, especially in low SDI countries. FUNDING National Nature Science Foundation of China. TRANSLATION For the Chinese translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Jinqiao Zhu
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China
| | - Yusha Cui
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Junjiao Zhang
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Rui Yan
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dongning Su
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dong Zhao
- Department of Epidemiology, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, Beijing, China
| | - Anxin Wang
- Department of Epidemiology, Beijing Neurosurgical Institute, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; Department of Clinical Epidemiology and Clinical Trial, Capital Medical University, Beijing, China; Beijing Municipal Key Laboratory of Clinical Epidemiology, Beijing, China.
| | - Tao Feng
- Center for Movement Disorders, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China.
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Nabizadeh F, Seyedmirzaei H, Rafiei N, Maryam Vafaei S, Shekouh D, Mehrtabar E, Mirzaaghazadeh E, Mirzaasgari Z. Global prevalence and incidence of Young Onset Parkinson's disease: A systematic review and meta-analysis. J Clin Neurosci 2024; 125:59-67. [PMID: 38754241 DOI: 10.1016/j.jocn.2024.05.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 04/20/2024] [Accepted: 05/10/2024] [Indexed: 05/18/2024]
Abstract
BACKGROUND There is a lack of enough evidence regarding the epidemiology of Young-onset Parkinson's disease (YOPD) which is needed by clinicians and healthcare policymakers. AIM Herein, in this systematic review and meta-analysis, we aimed to estimate the global prevalence and incidence rates of YOPD. METHODS We searched the literature in PubMed, Scopus, and Web of Science in May 2022. We included retrospective, prospective, cross-sectional observational population-based studies that reported the prevalence or incidence of PD in individuals younger than 40 years with known diagnostic criteria. RESULTS After two-step screening, 50 studies were eligible to be included in our study. The age-standardized prevalence of YOPD was 10.2 per 100,000 persons globally while it was 14.7 per 100,000 population in European countries. Age-standardized prevalence estimates for 5-year age bands showed that the YOPD prevalence estimates varied from 6.1 per 100,000 population in the group aged 20-24 to 16.1 per 100,000 population in the group aged 35-39. Also, the age-standardized incidence of YOPD was 1.3 per 100,000 person-years population worldwide and 1.2 per 100,000 person-years in the European population. CONCLUSION Based on this systematic review and meta-analysis, the overall prevalence of YOPD is 10.2 per 100,000 population, although estimates of the prevalence and incidence in low-income countries remain scarce. To improve monitoring and certain diagnoses of YOPD, healthcare providers and policymakers should be aware that much more effective tools are required.
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Affiliation(s)
- Fardin Nabizadeh
- School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Homa Seyedmirzaei
- School of Medicine, Tehran University of Medical Science, Tehran, Iran; Interdisciplinary Neuroscience Research Program (INRP) , Tehran University of Medical Sciences, Tehran, Iran
| | - Nazanin Rafiei
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Dorsa Shekouh
- Student Research Committee, School of Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ehsan Mehrtabar
- School of Medicine, Tehran University of Medical Science, Tehran, Iran
| | | | - Zahra Mirzaasgari
- Department of Neurology, Firoozgar Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
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Gialluisi A, De Bartolo MI, Costanzo S, Belvisi D, Falciglia S, Ricci M, Di Castelnuovo A, Panzera T, Donati MB, Fabbrini G, de Gaetano G, Berardelli A, Iacoviello L. Risk and protective factors in Parkinson's disease: a simultaneous and prospective study with classical statistical and novel machine learning models. J Neurol 2023; 270:4487-4497. [PMID: 37294324 DOI: 10.1007/s00415-023-11803-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Revised: 05/30/2023] [Accepted: 06/01/2023] [Indexed: 06/10/2023]
Abstract
BACKGROUND Several environmental/lifestyle factors have been individually investigated in previous Parkinson's disease (PD) studies with controversial results. No study has prospectively and simultaneously investigated potential risk/protective factors of PD using both classical statistical and novel machine learning analyses. The latter may reveal more complex associations and new factors that are undetected by merely linear models. To fill this gap, we simultaneously investigated potential risk/protective factors involved in PD in a large prospective population study using both approaches. METHODS Participants in the Moli-sani study were enrolled between 2005 and 2010 and followed up until December 2018. Incident PD cases were identified by individual-level record linkage to regional hospital discharge forms, the Italian death registry, and the regional prescription register. Exposure to potential risk/protective factors was assessed at baseline. Multivariable Cox Proportional Hazards (PH) regression models and survival random forests (SRF) were built to identify the most influential factors. RESULTS We identified 213 incident PD cases out of 23,901 subjects. Cox PH models revealed that age, sex, dysthyroidism and diabetes were associated with an increased risk of PD. Both hyper and hypothyroidism were independently associated with PD risk. SRF showed that age was the most influential factor in PD risk, followed by coffee intake, daily physical activity, and hypertension. CONCLUSION This study sheds light on the role of dysthyroidism, diabetes and hypertension in PD onset, characterized to date by an uncertain relationship with PD, and also confirms the relevance of most factors (age, sex, coffee intake, daily physical activity) reportedly shown be associated with PD. Further methodological developments in SRF models will allow to untangle the nature of the potential non-linear relationships identified.
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Affiliation(s)
- Alessandro Gialluisi
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, Italy
- Department of Medicine and Surgery, EPIMED Research Center, University of Insubria, Varese, Italy
| | | | - Simona Costanzo
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, Italy
| | - Daniele Belvisi
- IRCCS NEUROMED, Pozzilli, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | - Stefania Falciglia
- UOC Governance del Farmaco, Azienda Sanitaria Regionale del Molise -ASREM, Campobasso, Italy
| | - Moreno Ricci
- UOC Governance del Farmaco, Azienda Sanitaria Regionale del Molise -ASREM, Campobasso, Italy
| | | | - Teresa Panzera
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, Italy
| | | | - Giovanni Fabbrini
- IRCCS NEUROMED, Pozzilli, Italy
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy
| | | | - Alfredo Berardelli
- IRCCS NEUROMED, Pozzilli, Italy.
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
| | - Licia Iacoviello
- Department of Epidemiology and Prevention, IRCCS NEUROMED, Pozzilli, Italy
- Department of Medicine and Surgery, EPIMED Research Center, University of Insubria, Varese, Italy
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Zenesini C, Belotti LMB, Baccari F, Baldin E, Ridley B, Calandra-Buonaura G, Cortelli P, D'Alessandro R, Nonino F, Vignatelli L. Validation of Administrative Health Data Algorithms for Identifying Persons with Parkinson's Disease and the 10-Year Prevalence Trend in Bologna, Italy. Neuroepidemiology 2023; 57:336-344. [PMID: 37549643 DOI: 10.1159/000533362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Accepted: 07/27/2023] [Indexed: 08/09/2023] Open
Abstract
INTRODUCTION Health administrative databases are widely used for the estimation of the prevalence of Parkinson's disease (PD). Few in general, and none used in Italy, have been validated by testing their diagnostic accuracy. The primary objective was to validate two algorithms for the identification of persons with PD using clinical diagnosis as the reference standard on an Italian sample of people with PD. The second objective was to estimate 10-year trends in PD prevalence in the Bologna Local Health Trust from 2010 to 2019. METHODS Two algorithms (index tests) applied to health administrative databases (hospital discharge, drug prescriptions, exemptions for medical costs) were validated against clinical diagnosis of PD by an expert neurologist (reference standard) in a cohort of consecutive outpatients. Sensitivity and specificity with relative 95% confidence intervals (CIs) were calculated. The prevalence of PD in a specific year was estimated as the ratio between the number of subjects fulfilling any criteria of the algorithm with better diagnostic accuracy and the total population in the same year (×1,000), stratified by age, sex, and district of residence. RESULTS The two algorithms showed high accuracy for identifying patients with PD: one with greater sensitivity of 94.2% (CI: 88.4-97.6) and the other with greater specificity of 98.1% (CI: 97.7-98.5). For the estimation of prevalence, we chose the most specific algorithm with the fewest total number of misclassified cases. We identified 3,798 people with PD as of December 31, 2019, corresponding to a prevalence of 4.3 per 1,000 inhabitants (CI: 4.2-4.4). Prevalence was higher in males (4.7, CI: 4.5-5.0) than females (3.8, CI: 3.7-4.0) and increased with age. The crude prevalence over time was slightly elevated as it followed a progressive aging of the population. When stratifying the prevalence for age groups, we did not observe a trend except in the 45-64 year category where we observed an increasing trend over time. CONCLUSION Algorithms based on administrative data are accurate when detecting people with PD in the Italian public health system. In a large northern Italian population, increased prevalence of about 10% was observed in the decade 2010-2019 and is explained by increased life expectancy. These data may be useful in planning the allocation of health care resources for people with PD.
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Affiliation(s)
- Corrado Zenesini
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | | | - Flavia Baccari
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Elisa Baldin
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Ben Ridley
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Giovanna Calandra-Buonaura
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Dipartimento di Scienze Biomediche e NeuroMotorie, Università Degli Studi di Bologna, Bologna, Italy
| | - Pietro Cortelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
- Dipartimento di Scienze Biomediche e NeuroMotorie, Università Degli Studi di Bologna, Bologna, Italy
| | | | - Francesco Nonino
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
| | - Luca Vignatelli
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Bologna, Italy
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Zirra A, Rao SC, Bestwick J, Rajalingam R, Marras C, Blauwendraat C, Mata IF, Noyce AJ. Gender Differences in the Prevalence of Parkinson's Disease. Mov Disord Clin Pract 2022; 10:86-93. [PMID: 36699001 PMCID: PMC9847309 DOI: 10.1002/mdc3.13584] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2022] [Accepted: 09/03/2022] [Indexed: 01/28/2023] Open
Abstract
Background Parkinson's disease (PD) affects males more than females. The reasons for the gender differences in PD prevalence remain unclear. Objective The objective of this systematic review and meta-analysis was to update the overall male/female prevalence ratios (OPR). Methods We 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. Results We 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. Conclusion Gender 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.
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Affiliation(s)
- Alexandra Zirra
- Preventive Neurology UnitWolfson Institute of Population Health, Queen Mary University of LondonLondonUnited Kingdom
| | - Shilpa C. Rao
- Genomic Medicine InstituteLerner Research Institute, Cleveland Clinic FoundationClevelandOhioUSA,Department of Molecular MedicineCase Western Reserve UniversityClevelandOhioUSA
| | - Jonathan Bestwick
- Preventive Neurology UnitWolfson Institute of Population Health, Queen Mary University of LondonLondonUnited Kingdom
| | | | - Connie Marras
- University Health NetworkUniversity of TorontoTorontoOntarioCanada
| | - Cornelis Blauwendraat
- Laboratory of Neurogenetics, National Institute of AgingNational Institutes of HealthBethesdaMarylandUSA
| | - Ignacio F. Mata
- Genomic Medicine InstituteLerner Research Institute, Cleveland Clinic FoundationClevelandOhioUSA,Department of Molecular MedicineCase Western Reserve UniversityClevelandOhioUSA
| | - Alastair J. Noyce
- Preventive Neurology UnitWolfson Institute of Population Health, Queen Mary University of LondonLondonUnited Kingdom,Department of Clinical and Movement NeurosciencesUCL Institute of NeurologyLondonUnited Kingdom
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Cicero CE, Scondotto S, Allotta AV, De Luca G, Murolo G, Nicoletti A, Zappia M. Burden of Parkinson's disease in Sicily: a health administrative database study. Neurol Sci 2021; 43:1043-1046. [PMID: 34259973 DOI: 10.1007/s10072-021-05460-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 07/03/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION Prevalence of Parkinson's disease (PD) increases with the advanced ages, representing a relevant health burden. Accurate prevalence estimates are of fundamental need in order to adjust the supply of health services for these patients. The availability of administrative health data from the National Health System provides a useful resource to assess the burden of diseases. Our aim was to evaluate the prevalence of PD through the use of administrative data in the Sicily region. METHODS We have identified all the subjects affected by PD in Sicily in 2017 by gathering data from three regional health administrative databases: the hospital discharge records, the medical exemption databases, and the pharmacological prescription database. Prevalence rates and 95% confidence intervals (CI) have been calculated across 5-year age classes. RESULTS PD patients identified through database searching were 24,674, giving a prevalence of 488/100,000 (95%CI 481.9-494.1) inhabitants. Prevalence was higher among men (514.5/100,000; 95%CI 505.6-523.6) and reached a peak in the 85-89 age class (3203.8/100,000; 95%CI 3095.2-3315.1). DISCUSSION Our prevalence estimates of PD were higher when compared to previous epidemiological surveys conducted in Sicily. These findings are, however, comparable to other studies conducted in Italy that identified cases through administrative databases. Using health databases is a feasible strategy to assess the burden of PD.
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Affiliation(s)
- Calogero Edoardo Cicero
- Department of Medical, Surgical and Advanced Technologies, G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Salvatore Scondotto
- Health Activities and Epidemiologic Observatory Division, Health Department, Sicily Region, Palermo, Italy
| | | | - Giovanni De Luca
- Health Activities and Epidemiologic Observatory Division, Health Department, Sicily Region, Palermo, Italy
| | - Giuseppe Murolo
- Health Activities and Epidemiologic Observatory Division, Health Department, Sicily Region, Palermo, Italy
| | - Alessandra Nicoletti
- Department of Medical, Surgical and Advanced Technologies, G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy
| | - Mario Zappia
- Department of Medical, Surgical and Advanced Technologies, G.F. Ingrassia, Section of Neurosciences, University of Catania, Catania, Italy.
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Nrf2 as a potential target for Parkinson's disease therapy. J Mol Med (Berl) 2021; 99:917-931. [PMID: 33844027 DOI: 10.1007/s00109-021-02071-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 01/28/2021] [Accepted: 03/29/2021] [Indexed: 02/08/2023]
Abstract
Parkinson's disease (PD) is a complex neurodegenerative disorder featuring both motor and nonmotor symptoms associated with a progressive loss of dopaminergic neurons in the substantia nigra pars compacta. Conventionally, PD treatment options have focused on dopamine replacement and provide only symptomatic relief. However, disease-modifying therapies are still unavailable. Mechanistically, genetic and environmental factors can produce oxidative stress which has been implicated as a core contributor to the initiation and progression of PD through the degeneration of dopaminergic neurons. Importantly, nuclear factor erythroid 2-related factor 2 (Nrf2) is essential for maintaining redox homeostasis by binding to the antioxidant response element which exists in the promoter regions of most genes coding for antioxidant enzymes. Furthermore, protein kinase C, mitogen-activated protein kinases, and phosphotidylinositol 3-kinase have been implicated in the regulation of Nrf2 activity during PD. Here, we review the evidence supporting the regulation of Nrf2 through Keap1-dependent and Keap1-independent mechanisms. We also address that targeting Nrf2 may provide a therapeutic option to mitigate oxidative stress-associated PD. Finally, we discuss currently known classes of small molecule activators of Nrf2, including Nrf2-activating compounds in PD.
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Riccò M, Vezzosi L, Balzarini F, Gualerzi G, Ranzieri S, Signorelli C, Colucci ME, Bragazzi NL. Prevalence of Parkinson Disease in Italy: a systematic review and meta-analysis. ACTA BIO-MEDICA : ATENEI PARMENSIS 2020; 91:e2020088. [PMID: 32921784 PMCID: PMC7717000 DOI: 10.23750/abm.v91i3.9443] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/21/2020] [Accepted: 04/06/2020] [Indexed: 02/07/2023]
Abstract
Introduction: Parkinson’s disease (PD) is a common disease of unknown etiology. Even though accurate information on the epidemiology of PD is critical for defining appropriate health policies, epidemiological data on Parkinson’s disease (PD) in Italy are often defined as scant or conflicting. Our study attempted to provide an overview on the prevalence of (PD) by means of a systematic review and metanalysis of existing data. Material and methods: We searched into two different databases (PubMed and EMBASE), focusing on studies reporting the prevalence of PD in Italy. Data were extracted using a standardized assessment form, and results of such analyses were systematically reported, summarized and compared. Results: A total of 16 studies were eventually included in the analyses, with a prevalence rate of 193.7/100,000. Available reports were heterogeneous both in design and in eventual figures, and also prevalence estimates were affected by substantial heterogeneity. Interestingly, prevalence rates ranged from 37.8/100,000 inhabitants in subjects aged 0 to 64 years, to 578.7 in age group 65 to 75 years, and 1235.7 in age group 75 years or older. PD was significantly associated with male sex, but only in older age groups (i.e. Odds Ratio, OR 1.37 95%CI 1.22-1.53, and OR 1.31, 95%CI 1.21-1.42 for age groups 65-74 years and 75 years or more, respectively). Discussion and conclusion: While the observed variations in prevalence rates may result from environmental or genetic factors, differences in methodologies for case ascertainment and diagnostic criteria may have significantly affected our estimates. As a consequence, the comparability of existing studies is limited.
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Affiliation(s)
- Matteo Riccò
- Azienda USL di Reggio EmiliaV.le Amendola n.2 - 42122 REServizio di Prevenzione e Sicurezza negli Ambienti di Lavoro (SPSAL)Dip. di Prevenzione.
| | - Luigi Vezzosi
- Agenzia di Tutela della Salute (ATS) della Val Padana; Via Toscani n.1; Mantova (MN), Italy.
| | - Federica Balzarini
- University "Vita e Salute", San Raffaele Hospital; Via Olgettina n. 58, 20132; Milan (MI), Italy.
| | - Giovanni Gualerzi
- University of Parma, Department of Medicine and Surgery, School of Medicine; Via Gramsci n.14, 43123; Parma (PR), Italy.
| | - Silvia Ranzieri
- University of Parma, Department of Medicine and Surgery, School of Occupational Medicine; Via Gramsci n.14, 43123; Parma (PR), Italy.
| | - Carlo Signorelli
- University "Vita e Salute", San Raffaele Hospital; Via Olgettina n. 58, 20132; Milan (MI), Italy.
| | - Maria Eugenia Colucci
- University of Parma, Department of Medicine and Surgery, School of Hygiene and Public Health; Via Gramsci n.14, 43123; Parma (PR), Italy.
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, University of York, Toronto (ON), Canada.
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Taborelli M, Sozzi M, Del Zotto S, Toffolutti F, Montico M, Zanier L, Serraino D. Risk of intestinal and extra-intestinal cancers in patients with inflammatory bowel diseases: A population-based cohort study in northeastern Italy. PLoS One 2020; 15:e0235142. [PMID: 32574216 PMCID: PMC7310697 DOI: 10.1371/journal.pone.0235142] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2020] [Accepted: 06/09/2020] [Indexed: 12/12/2022] Open
Abstract
The cancer risk of patients with inflammatory bowel diseases (IBD) has not been well documented in southern Europe. This study aimed to evaluate the overall pattern of cancer risk among patients with IBD in Friuli Venezia Giulia, northeastern Italy. A population-based cohort study was performed through a record linkage between local healthcare databases and the cancer registry (1995–2013). We identified 3664 IBD patients aged 18–84 years, including 2358 with ulcerative colitis (UC) and 1306 with Crohn’s disease (CD). Sex- and age-standardized incidence ratios (SIRs) and 95% confidence intervals (CIs) were used to compare the cancer incidence of IBD patients with the general population. The cumulative cancer risk among IBD patients reached about 10% after 10 years of follow-up. A total of 246 cancers occurred among UC patients (SIR = 1.05, 95% CI: 0.92–1.19), and 141 among CD patients (SIR = 1.20, 95% CI: 1.01–1.41). As compared with the general population, no increased risk of colorectal cancers was observed for either UC or CD patients, whereas the risk of anal cancer was significantly elevated among UC patients (SIR = 6.03, 95% CI: 1.24–17.60). Increased risks were seen for specific extra-intestinal cancers, including corpus uteri (SIR = 2.67, 95% CI: 1.07–5.50) and kidney (SIR = 2.06, 95% CI: 1.03–3.69) among UC patients; thyroid (SIR = 5.58, 95% CI: 2.41–11.00) and skin non-melanoma (SIR = 1.86, 95% CI: 1.32–2.55) among CD patients. This population-based study showed that both UC and CD patients had a colorectal cancer risk similar to that of the general population. However, they were at a higher risk of developing certain extra-intestinal cancer types. Although detection biases cannot be excluded, the study findings pointed to a role of long-standing exposures to immunosuppressive therapies, underlying disease status, as well as the interactions with lifestyle factors. Our findings lent additional support to the need for monitoring the cancer burden in this at-risk population.
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Affiliation(s)
- Martina Taborelli
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
- * E-mail:
| | - Michele Sozzi
- Friuli Venezia Giulia Cancer Registry, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Stefania Del Zotto
- SC Data Warehouse, Flussi Informativi ed Epidemiologia, Agenzia Regionale di Coordinamento per la Salute, Udine, Italy
| | - Federica Toffolutti
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Marcella Montico
- Scientific Directorate, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
| | - Loris Zanier
- SC Data Warehouse, Flussi Informativi ed Epidemiologia, Agenzia Regionale di Coordinamento per la Salute, Udine, Italy
| | - Diego Serraino
- Cancer Epidemiology Unit, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
- Friuli Venezia Giulia Cancer Registry, Centro di Riferimento Oncologico di Aviano (CRO) IRCCS, Aviano, Italy
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Berardi A, Galeoto G, Valente D, Conte A, Fabbrini G, Tofani M. Validity and reliability of the 12-item Berg Balance Scale in an Italian population with Parkinson's disease: A cross sectional study. ARQUIVOS DE NEURO-PSIQUIATRIA 2020; 78:419-423. [PMID: 32520233 DOI: 10.1590/0004-282x20200030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 02/26/2020] [Indexed: 01/04/2023]
Abstract
BACKGROUND The Berg Balance Scale is widely used to measure balance ability in clinical practice. Recently, the original version was redefined from 14 into 12 items. Its psychometric properties were investigated for different populations. However, for Parkinson disease the new version has not been validated yet. OBJECTIVE The purpose of the present study was to evaluate psychometric properties of the 12-item Berg Balance Scale (BBS-12) in a population with Parkinson disease. METHODS Internal consistency was evaluated with Cronbach's alpha coefficient, whereas reliability was assessed with the intraclass correlation coefficient. For validity analysis, the Pearson correlation coefficient of the BBS-12 was evaluated with the Tinetti Scale and the Physical Activity Scale for the Elderly. RESULTS The BBS-12 was applied to 50 individuals with a mean age of 65.6 years (SD 11.8). The internal consistency showed a good value (Cronbach's alpha 0.886) and reproducibility reveled very high performances for both inter-rater and intra-rater reliabilities (ICC 0.987 and 0.986, respectively). The validity study demonstrated good linear correlation with the Tinetti Scale (p<0.01) and with the Sport and Home Subscales of the Physical Activity Scale for the Elderly (p<0.01). CONCLUSIONS The present findings revealed the BBS-12 as a reliable and valid assessment tool to measure balance ability in Parkinson disease. Italian health professionals can now use it with more confidence.
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Affiliation(s)
| | - Giovanni Galeoto
- Dipartimento di Sanità Pubblica e Malattie Infettive, Sapienza Università di Roma, Rome, LZ, Italy
| | - Donatella Valente
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, LZ, Italy
| | - Antonella Conte
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, LZ, Italy
| | - Giovanni Fabbrini
- Dipartimento di Neuroscienze Umane, Sapienza Università di Roma, Rome, LZ, Italy
| | - Marco Tofani
- Ospedale Pediatrico Bambino Gesù, Dipartimento di Neuroscienze e Neuroriabilitazione, Unità di Neuroriabilitazione, Fiumicino, RM, Italy
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Valent F, Deroma L, Moro A, Ciana G, Martina P, De Martin F, Michelesio E, Da Riol MR, Macor D, Bembi B. Value of the Rare Disease Registry of the Italian Region Friuli Venezia Giulia. VALUE IN HEALTH : THE JOURNAL OF THE INTERNATIONAL SOCIETY FOR PHARMACOECONOMICS AND OUTCOMES RESEARCH 2019; 22:1003-1011. [PMID: 31511176 DOI: 10.1016/j.jval.2019.04.1917] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 03/27/2019] [Accepted: 04/04/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND The lack of epidemiological and clinical data is a major obstacle in health service planning for rare diseases. Patient registries are examples of real-world data that may fill the information gap. OBJECTIVE We describe the Rare Disease Registry of the Friuli Venezia Giulia region of Italy and its potential for research and health planning. METHODS The Rare Disease Registry data were linked with information on mortality, hospital discharges, ambulatory care, and drug prescriptions contained in administrative databases. All information is anonymous, and data linkage was based on a stochastic key univocal for each patient. Average annual costs owing to hospitalizations, outpatient care, and medications were estimated. RESULTS Implementation of the Registry started in 2010, and 4250 participants were registered up to 2017. A total of 2696 patients were living in the region as of January 1, 2017. The overall raw prevalence of rare diseases was 22 per 10,000 inhabitants, with higher prevalence in the pediatric population. The most common disease groups were congenital malformations, chromosomal and genetic syndromes, and circulatory and nervous diseases. In 2017, 30 patients died, 648 were hospitalized, and 2355 received some type of ambulatory care. The total annual estimated cost was approximately €6.5 million, with great variability in the average patient cost across diseases. CONCLUSIONS The possibility of following the detailed real-world care experience of patients with each specific rare disease and assessing the costs related to each step in their care path represents a unique opportunity to identify inefficiencies, optimize care, and reduce waste of resources.
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Affiliation(s)
- Francesca Valent
- Institute of Hygiene and Clinical Epidemiology, University Hospital of Udine, Udine, Italy.
| | - Laura Deroma
- Regional Coordinating Center for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Alessandro Moro
- Regional Coordinating Center for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Giovanni Ciana
- Regional Coordinating Center for Rare Diseases, University Hospital of Udine, Udine, Italy
| | | | | | | | - Maria Rosalia Da Riol
- Regional Coordinating Center for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Daniela Macor
- Regional Coordinating Center for Rare Diseases, University Hospital of Udine, Udine, Italy
| | - Bruno Bembi
- Regional Coordinating Center for Rare Diseases, University Hospital of Udine, Udine, Italy
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Eusebi P, Franchini D, De Giorgi M, Abraha I, Montedori A, Casucci P, Calabresi P, Tambasco N. Incidence and prevalence of Parkinson's disease in the Italian region of Umbria: a population-based study using healthcare administrative databases. Neurol Sci 2019; 40:1709-1712. [PMID: 30945089 DOI: 10.1007/s10072-019-03872-w] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Accepted: 03/25/2019] [Indexed: 12/15/2022]
Abstract
Parkinson's disease is known to pose a significant burden on society in industrialized countries. However, few studies have been conducted in Italy using administrative healthcare databases for epidemiological purposes. We wanted to estimate the incidence and prevalence rates of Parkinson's disease in the Italian region of Umbria by means of linkage between several sources of administrative healthcare data: hospitalization episodes, exemptions from medical charges, drug prescriptions from general practitioners and physicians working in the public sector. Using a pre-defined algorithm, we estimated incident and prevalent cases of Parkinson's disease for the year 2016. The regional incidence rate, adjusted with Italian standard population data, was 0.40 new cases/1000 person-years (0.41 in females, 0.39 in males). We estimated that 5550 subjects were affected by Parkinson's disease, leading to an age-adjusted prevalence rate of 5.42/1000 inhabitants. Prevalence and incidence increased with age and male gender. However, due to the longer life expectancy of females, the absolute number of prevalent cases was greater among females. The heterogeneity of spatial distribution of disease was high. A considerable proportion of prevalent cases was hospitalized in 2016. The most recurrent reasons for hospitalization episodes were disorders related to the nervous system, respiratory system, cardiovascular system, and musculoskeletal and connective tissue apparatus. The study findings support the feasibility of future epidemiological studies of Parkinson's disease with administrative data as well as the need for an integrative care pathway for the patients with Parkinson's disease.
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Affiliation(s)
- Paolo Eusebi
- Regional Health Authority of Umbria, Perugia, Italy. .,Neurology Clinic, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy.
| | | | | | | | | | | | - Paolo Calabresi
- Neurology Clinic, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy.,Fondazione IRCSS Santa Lucia, Rome, Italy
| | - Nicola Tambasco
- Neurology Clinic, University of Perugia, Ospedale S. Maria della Misericordia, Perugia, Italy
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Galeoto G, Colalelli F, Massai P, Berardi A, Tofani M, Pierantozzi M, Servadio A, Fabbrini A, Fabbrini G. Quality of life in Parkinson's disease: Italian validation of the Parkinson's Disease Questionnaire (PDQ-39-IT). Neurol Sci 2018; 39:1903-1909. [PMID: 30088166 DOI: 10.1007/s10072-018-3524-x] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 08/03/2018] [Indexed: 12/24/2022]
Abstract
Translation and cross-cultural adaptation of the 39-item Parkinson's Disease Questionnaire (PDQ-39) to the Italian culture was performed by Oxford University Innovation in 2008, but this version has never been validated. Therefore, we performed the process of validation of the Italian version of the PDQ-39 (PDQ-39-IT) following the "Consensus-Based Standards for the Selection of Health Status Measurement Instruments" checklist. The translated PDQ-39-IT was tested with 104 patients diagnosed with Parkinson's disease (PD) who were recruited between June and October 2017. The mean age of the participants was 65.7 ± 10.2 years, and the mean duration of symptoms was 7.4 ± 5.3 years. The internal consistency of the PDQ-39-IT was assessed by Cronbach's alpha and ranged from 0.69 to 0.92. In an assessment of test-retest reliability in 35 of the 104 patients, the infraclass correlation coefficient (ICC) ranged from 0.85 to 0.96 for the various subitems of the PDQ-39-IT (all p < 0.01). Spearman's rank correlation coefficient for the validity of the PDQ-39-IT and the Italian version of the 36-Item Short Form (SF-36) was - 0.50 (p < 0.01). The results show that the PDQ-39-IT is a reliable and valid tool to assess the impact of PD on functioning and well-being. Thus, the PDQ-39-IT can be used in clinical and research practice to assess this construct and to evaluate the overall effect of different treatments in Italian PD patients.
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Affiliation(s)
- Giovanni Galeoto
- Department of Public Health, Sapienza University of Rome, Rome, Italy
| | | | | | | | - Marco Tofani
- Department of Neurosciences and Neurorehabilitation, Bambino Gesù Children's Hospital, Rome, Italy
| | | | - Annamaria Servadio
- Department of Health Professions, "Tor Vergata" University of Rome, Rome, Italy
| | - Andrea Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy
| | - Giovanni Fabbrini
- Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università 30, 00185, Rome, Italy. .,IRCCS Neuromed, Pozzilli, IS, Italy.
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