Pezzoli Gianni, Klersy Catherine, Cilia Roberto, Canesi Margherita, Zecchinelli Anna Lena, Mariani Claudio Bruno, Tesei Silvana, Sacilotto Giorgio, Meucci Nicoletta, Zini Michela, Isaias Ioannis Ugo, Ruffmann Claudio, Barichella Michela, Cassani Erica, Goldwurm Stefano, Cereda Emanuele
Parkinson Institute - Istituti Clinici di Perfezionamento, Milano, Italy.
Biometry and Statistics Service, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy.
Parkinsonism Relat Disord. 2014 Nov;20(11):1181-5. doi: 10.1016/j.parkreldis.2014.08.017. Epub 2014 Sep 3.
Age is considered an important risk factor for Parkinson's disease (PD). However, although life-expectancy has increased considerably, incidence rates of PD appeared to be stable over the last two decades. Accordingly, an increase in mean age at onset over time could be expected. We investigated the changes in age at onset in PD over the last two decades.
All consecutive PD patients assessed over a 18-year period (1995-2013) in a single tertiary outpatient clinic were included in the present retrospective cohort study.
After adjusting for several confounders (gender, positive family history for PD, education, smoking at onset and past exposure to environmental/occupational pollutants), 5-year cohorts of year of disease onset were associated with increasing age at onset in both prevalent (N = 6996) and incident (N = 4172) cases (for trend, P < 0.001). From 1995-2000 to 2010-2013 there was an increase in predicted age of 4.1 years (95% CI, 3.0-5.2) and 3.9 years (95% CI, 2.7-5.1) in prevalent and incident cases, respectively. However, the change in predicted age at PD onset, across cohorts of year at onset, showed a steeper increase than the corresponding sex and cohort-matched mean age from the official Italian statistics.
Over the last two decades, age at onset of PD appeared to shift progressively towards more advanced age. However, sequential, high-quality population-based incidence studies are required. To establish whether there is a trend towards increase in age at onset over and above general population ageing and to assess whether the increase is associated with improved medical and socio-economic conditions.
年龄被认为是帕金森病（PD）的一个重要风险因素。然而，尽管预期寿命已大幅提高，但在过去二十年中，PD的发病率似乎保持稳定。因此，可以预期发病的平均年龄会随时间增加。我们调查了过去二十年中PD发病年龄的变化。
本回顾性队列研究纳入了在一家单一的三级门诊诊所18年期间（1995 - 2013年）评估的所有连续PD患者。
在调整了几个混杂因素（性别、PD家族史阳性、教育程度、发病时吸烟情况以及过去接触环境/职业污染物的情况）后，疾病发病年份的5年队列与现患（N = 6996）和新发病例（N = 4172）的发病年龄增加相关（趋势检验，P < 0.001）。从1995 - 2000年到2010 - 2013年，现患和新发病例的预测年龄分别增加了4.1岁（95%CI，3.0 - 5.2）和3.9岁（95%CI，2.7 - 5.1）。然而，PD发病预测年龄在发病年份队列中的变化比意大利官方统计中相应的性别和队列匹配的平均年龄增加得更陡峭。
在过去二十年中，PD的发病年龄似乎逐渐向更高龄偏移。然而，需要进行连续的、基于高质量人群的发病率研究，以确定发病年龄的增加是否超过一般人群老龄化趋势，并评估这种增加是否与医疗和社会经济条件的改善有关。
