Prevalence of parkinsonism and Parkinson disease in urban and rural populations from Latin America: A community based study

• Type of Material: Article
• Authors: Jorge J Llibre-Guerra, Washington University School of Medicine in St. Louis; Matthew Prina, King's College London; Ana Luisa Sosa, National Autonomous University of Mexico; Daisy Acosta, Universidad Nacional Pedro Henriquez Ureña (UNPHU); Ivonne Z Jimenez-Velazquez, University of Puerto Rico; Mariella Guerra, Instituto de la Memoria Depresion y Enfermedades de Riesgo IMEDER; Aquiles Salas, Universidad Central de Venezuela; Juan C Llibre-Guerra, Hospital del Mar, Barcelona; Adolfo Valvuerdi, University of Matanzas; Geeske Peeters, Radboud University Medical Center; Ellen Ziegemeier, Washington University School of Medicine in St. Louis; Isaac Acosta, Universidad Nacional Autónoma de México; Caroline Tanner, University of San Francisco; Jorge Juncos, Emory University; Juan J Llibre Rodriguez, Medical University of Havana
• Language: English
• Date: 2022-03-01
• Publisher: Elsevier
• Publication Version: Final Published Version
• Copyright Statement: © 2021 The Author(s)
• License: Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1016/j.lana.2021.100136
• Title of Journal or Parent Work: The Lancet Regional Health - Americas
• Volume: 7
• Grant/Funding Information: The 10/66 Dementia Research Group's research has been funded by the Wellcome Trust Health Consequences of Population Change Programme (GR066133 – Prevalence phase in Cuba and Brazil; GR080002- Incidence phase in Peru, Mexico, Argentina, Cuba, Dominican Republic, Venezuela, and China), the World Health Organization (India, Dominican Republic, and China), the US Alzheimer's Association (IIRG – 04 – 1286 - Peru, Mexico, and Argentina), the Puerto Rico State Legislature (Puerto Rico), and FONACIT/ CDCH/ UCV (Venezuela). Secondary data analysis on parkinsonism and Parkinson disease in the 10/66 Latin American countries is supported by the Michael J. Fox Foundation (MJFF-020770).
• Keywords: Parkinsonism; Latin America; Parkinson's disease; Risk factors; Prevalence
• Research Categories: Biology, Neuroscience

Abstract

Background: Age and gender specific prevalence rates for parkinsonism and Parkinson's disease (PD) are important to guide research, clinical practice, and public health planning; however, prevalence estimates in Latin America (LatAm) are limited. We aimed to estimate the prevalence of parkinsonism and PD and examine related risk factors in a cohort of elderly individuals from Latin America (LatAm). Methods: Data from 11,613 adults (65+ years) who participated in a baseline assessment of the 10/66 study and lived in six LatAm countries were analyzed to estimate parkinsonism and PD prevalence. Crude and age-adjusted prevalence were determined by sex and country. Diagnosis of PD was established using the UK Parkinson's Disease Society Brain Bank's clinical criteria. Findings: In this cohort, the prevalence of parkinsonism was 8.0% (95% CI 7.6%–8.5%), and the prevalence of PD was 2.0% (95% CI 1.7%–2.3%). PD prevalence increased with age from 1.0 to 3.5 (65–69vs. 80 years or older, p < 0.001). Age-adjusted prevalence rates were lower for women than for men. No significant differences were found across countries, except for lower prevalence in urban areas of Peru. PD was positively associated with depression (adjusted prevalence ratio [aPR] 2.06, 95% CI 1.40–3.01, I2 = 56.0%), dementia (aPR 1.57, 95% CI 1.07- 2.32, I2 = 0.0%) and educational level (aPR 1.14, 95% CI 1.01– 1.29, I2 = 58.6%). Interpretation: The reported prevalence of PD in LatAm is similar to reports from high-income countries (HIC). A significant proportion of cases with PD did not have a previous diagnosis, nor did they seek any medical or neurological attention. These findings underscore the need to improve public health programs for populations currently undergoing rapid demographic aging and epidemiological transition. Funding: The funding source had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.