Objective
To provide an overview on the prevalence and incidence of Parkinson's disease (PD) in selected European countries.
Background
PD is a common disease of unknown etiology. Accurate information on the epidemiology of PD is critical to inform health policy. An aging population will lead to more patients with PD; thus, the high financial burden PD places on society will increase.
Material and methods
A systematic literature search was performed to identify studies on the prevalence and incidence of PD in the following European countries: Austria, the Czech Republic, France, Germany, Italy, The Netherlands, Portugal, Spain, Sweden and United Kingdom. Only published studies were included. Abstracts, reviews, meta-analyses and letters to the editor were excluded. There were no language restrictions. Data were extracted using a standardized assessment form, and evidence tables were used to systematically report and compare the data.
Results
Of 39 identified studies, most (87%) reported estimates of PD prevalence rates, while only a few (13%) reported estimates of PD annual incidence rates. Crude prevalence rate estimates ranged from 65.6 per 100,000 to 12,500 per 100,000 and annual incidence estimates ranged from 5 per 100,000 to 346 per 100,000. No publications could be identified for Austria or the Czech Republic.
Discussion and conclusion
The observed variations in prevalence and incidence rates may result from environmental or genetic factors, but might also be a consequence of differences in methodologies for case ascertainment, diagnostic criteria, or age distributions of the study populations. The comparability of existing studies is limited.
Parkinson's disease (PD) is characterised by bradykinesia, tremor, rigidity and impaired postural reflexes. In addition to the motor symptoms, mental disorders like depression or psychosis, and autonomic and gastrointestinal dysfunction may occur; all of these disorders considerably impair the quality of life of PD patients (Schrag et al., 2000b). Although the cerebral structures undergoing neurodegeneration in PD are well characterised, the underlying mechanisms of the disease are still unknown. PD is one of the most common neurodegenerative diseases and its relentless progression results in severe disability.
Data on the prevalence and incidence of PD are of particular interest for several reasons: (1) epidemiological studies can provide insights into suspected risk factors, protective factors, and primary causes of disease, and may be used to investigate the natural history of PD; (2) by providing critical information on the burden of a particular disease to the population, epidemiological data can inform public health planning. The latter has become of pivotal interest in recent years as longevity of the population increases and the incidence of PD rises with age. Its high financial burden adds to the need for accurate information on its epidemiology (Spottke et al., in press). To date, epidemiological studies of PD have not been published for all European countries (Table 1). Crude incidence rates reported in various studies and populations range from 5/100,000 to 26/100,000 (Twelves et al., 2003). Environmental and genetic factors are discussed as reasons for variations in these data; however, other differences, such as methodological diversity, may also play a role.
Table 1.
Epidemiological studies in the different European countries
Country Prevalence data Incidence data Reference
Austria − − −
Belgium − − −
Cyprus − − −
Czech Republic − − −
Denmark + + (Dupont, 1977)
Estonia + + (Taba and Asser, 2002)
Finland + + (Marttila and Rinne, 1976)
France + − *
Germany + − *
Greece − − −
Hungary − − −
Iceland + +(idiopathic and artheriosclerotic) (Gudmundsson, 1967)
Ireland − − −
Italy + + *
Latvia − − −
Lithuania − − −
Luxembourg − − −
Malta − − −
Netherlands + + *
Norway + − (Tandberg et al., 1995)
Poland + + (Wender et al., 1989)
Portugal + (+) *
Slovakia − − −
Slovenia − − −
Spain + + *
Sweden + + *
Switzerland − − −
United Kingdom + + *
−: No data available; +: data available. *See tables below.
Table options
This survey will provide an overview on the prevalence and incidence of PD in the following European countries: Austria (A), Czech Republic (CZ), France (F), Germany (G), Italy (I), The Netherlands (NL), Portugal (P), Spain (E), Sweden (S), and the United Kingdom (UK). In particular, we focus on the methodologies used in the respective studies (Fig. 1).
Full-size image (93 K)
Fig. 1.
Studies available in Europe.
