帕金森病的地理和种族差异：美国医疗保险受益人的基于人群的研究。
Geographic and ethnic variation in Parkinson disease: a population-based study of US Medicare beneficiaries.
机构信息
Department of Neurology, Washington University School of Medicine, 660 South Euclid Avenue, Campus Box 8111, St. Louis, MO 63110, USA.
出版信息
Neuroepidemiology. 2010;34(3):143-51. doi: 10.1159/000275491. Epub 2010 Jan 15.
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.
背景
帕金森病是一种常见的神经退行性疾病。在美国，帕金森病的种族、性别、年龄和地理分布情况尚不清楚。
方法
我们对美国医疗保险和医疗补助服务中心（Medicare） 1995 年和 2000-2005 年期间年龄在 65 岁及以上的受益人的数据进行了一系列的横断面研究。我们每年使用超过 450,000 例帕金森病病例，按种族、年龄、性别和县计算了帕金森病的患病率和年发病率。空间分析研究了帕金森病的地理分布情况。
结果
白人男性的标准化帕金森病患病率（每 10 万人）为 2,168.18（+/-95.64），而黑人患病率为 1,036.41（+/-86.01），亚洲人患病率为 1,138.56（+/-46.47）。与白人相比，黑人的发病率比值（0.74；95%可信区间=0.732-0.748）高于患病率比值（0.58；95%可信区间=0.575-0.581），而亚洲人的发病率比值（0.69；95%可信区间=0.657-0.723）与患病率比值（0.62；95%可信区间=0.617-0.631）相似。帕金森病的贝叶斯映射显示出在中西部和东北部地区的集中分布。按 quartile 划分的县平均发病率范围为 279 至 3,111，患病率范围为 1,175 至 13,800（每 10 万人）。城市县的患病率和发病率均高于农村县（p<0.01）。聚类分析支持新发和现患帕金森病病例的分布均无随机性（p<0.001）。
结论
在美国，帕金森病在白人中更为常见，并且在中西部和东北部地区的分布是非随机的。
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