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基于二次索赔数据估算老年人中帕金森病(PD)的患病率以及伴有痴呆和抑郁症患者的比例。

Estimating the prevalence of Parkinson's disease (PD) and proportions of patients with associated dementia and depression among the older adults based on secondary claims data.

作者信息

Riedel O, Bitters D, Amann U, Garbe E, Langner I

机构信息

Leibniz Institute for Prevention Research and Epidemiology - BIPS, Bremen, Germany.

GWQ ServicePlus AG, Düsseldorf, Germany.

出版信息

Int J Geriatr Psychiatry. 2016 Aug;31(8):938-43. doi: 10.1002/gps.4414. Epub 2016 Jan 14.

Abstract

OBJECTIVES

While the epidemiology of Parkinson's disease (PD) has been extensively studied, data on the prevalence of PD among the older adults in Germany are scarce, based on small samples, and limited to primary data designs. This study estimated the PD prevalence among the older adults in Germany in 2006 using secondary data.

METHODS

We included 815,573 health insurance members aged ≥65 years from all regions in Germany. PD was identified in case of at least one inpatient or outpatient diagnosis. An outpatient diagnosis had to be confirmed by either a subsequent diagnosis or an antiparkinsonian drug within 12 months. PD was also assumed if a first prescription was confirmed by a diagnosis within 12 months. Cases were checked for a diagnosis of dementia or depression.

RESULTS

The standardized prevalence of PD was 1680 (95% confidence interval (CI): 1644-1716) cases per 100,000 persons. The prevalence increased with age and peaked in the age group of ≥90 years (4633 cases; 95% CI: 4227-5068) with higher rates in men (1729; 95% CI: 1684-1776) than in women (1644; 95% CI: 1593-1697). Dementia and depression occurred in 26.6% (95% CI: 25.8-27.5) and 32.6 (95% CI: 31.7-33.5) of PD cases, respectively.

CONCLUSIONS

The age-related increase of PD prevalence and the age-specific prevalence estimates are in line with other European studies, stressing the public health relevance related to PD. In addition to the minimization of biases that might occur in primary data studies, further strengths of our findings are the large underlying sample size and the coverage of Germany.

摘要

目的

虽然帕金森病(PD)的流行病学已得到广泛研究,但基于小样本且限于原始数据设计,德国老年人中PD患病率的数据稀缺。本研究使用二手数据估计了2006年德国老年人中的PD患病率。

方法

我们纳入了来自德国所有地区的815573名年龄≥65岁的医疗保险参保人。若有至少一次住院或门诊诊断,则认定为PD。门诊诊断必须通过后续诊断或12个月内的抗帕金森药物来确认。若首次处方在12个月内被诊断所证实,也假定为PD。对病例进行痴呆或抑郁症诊断检查。

结果

PD的标准化患病率为每10万人中有1680例(95%置信区间(CI):1644 - 1716)。患病率随年龄增长而增加,在≥90岁年龄组达到峰值(4633例;95%CI:4227 - 5068),男性患病率(1729;95%CI:1684 - 1776)高于女性(1644;95%CI:1593 - 1697)。痴呆和抑郁症分别发生在26.6%(95%CI:25.8 - 27.5)和32.6%(95%CI:31.7 - 33.5)的PD病例中。

结论

PD患病率随年龄增长以及特定年龄患病率估计与其他欧洲研究一致,强调了与PD相关的公共卫生意义。除了尽量减少原始数据研究中可能出现的偏差外,我们研究结果的其他优势在于庞大的基础样本量和德国的覆盖范围。

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