Brakedal Brage, Toker Lilah, Haugarvoll Kristoffer, Tzoulis Charalampos
Neuro-SysMed, Department of Neurology, Haukeland University Hospital, 5021, Bergen, Norway.
Department of Clinical Medicine, University of Bergen, Pb 7804, 5020, Bergen, Norway.
NPJ Parkinsons Dis. 2022 Mar 2;8(1):19. doi: 10.1038/s41531-022-00280-4.
Epidemiological studies of Parkinson's disease (PD) show variable and partially conflicting findings with regard to incidence, prevalence, and mortality. These differences are commonly attributed to technical and methodological factors, including small sample sizes, differences in diagnostic practices, and population heterogeneity. We leveraged the Norwegian Prescription Database, a population-based registry of drug prescriptions dispensed from Norwegian pharmacies to assess the incidence, prevalence, and mortality of PD in Norway. The diagnosis of PD was defined based on the prescription of dopaminergic drugs for the indication of PD over a continuous time. During 2004-2017, 12,229 males and 9831 females met our definition for PD diagnosis. PD prevalence increased over the observation period, with larger changes observed in the older age groups. Incidence and prevalence of PD increased with age, peaking at 85 years. The male/female prevalence ratio was 1.5 across all ages, whereas the incidence ratio increased with age, from 1.4 in those 60 years, to 2.03 among those >90 years. While PD mortality was generally higher than that of the general population, mortality odds ratios decreased with age, approaching 1.0 among individuals >90 years old. When adjusted for the sex-specific mortality of the general population, the mortality among females with PD was equal to or higher than the mortality among males with PD. Our findings demonstrate that the epidemiological features of PD, including sex-differences, are age and time-period dependent and indicate that sex differences in PD mortality are unlikely to stem from disease-specific negative impact of survival in males.
帕金森病（PD）的流行病学研究在发病率、患病率和死亡率方面呈现出多样且部分相互矛盾的结果。这些差异通常归因于技术和方法因素，包括样本量小、诊断实践差异以及人群异质性。我们利用挪威处方数据库（一个基于人群的挪威药房发放药物处方登记系统）来评估挪威PD的发病率、患病率和死亡率。PD的诊断基于连续一段时间内用于PD指征的多巴胺能药物处方。在2004 - 2017年期间，12229名男性和9831名女性符合我们的PD诊断定义。在观察期内PD患病率有所上升，老年组变化更为明显。PD的发病率和患病率随年龄增长而增加，在85岁时达到峰值。各年龄段的男/女患病率比值为1.5，而发病率比值随年龄增长，从60岁人群的1.4增至90岁以上人群的2.03。虽然PD死亡率总体高于一般人群，但死亡比值比随年龄下降，90岁以上个体接近1.0。当根据一般人群的性别特异性死亡率进行调整后，PD女性的死亡率等于或高于PD男性的死亡率。我们的研究结果表明，PD的流行病学特征，包括性别差异，取决于年龄和时间段，并表明PD死亡率的性别差异不太可能源于男性生存中疾病特异性的负面影响。
