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Neurology 1999;52:1214
© 1999 American Academy of Neurology
Articles

Incidence and distribution of parkinsonism in Olmsted County, Minnesota, 1976–1990

James H. Bower, MD, Demetrius M. Maraganore, MD, Shannon K. McDonnell, MS and Walter A. Rocca, MD, MPH

From the Departments of Neurology (Drs. Bower, Maraganore, and Rocca) and Health Sciences Research (Dr. Rocca and S.K. McDonnell), Mayo Clinic and Mayo Foundation, Rochester, MN.

Address correspondence and reprint requests to Dr. James H. Bower, Department of Neurology, Mayo Clinic, 200 First St. SW, Rochester, MN 55905.

OBJECTIVE: Limited information is available on the frequency and distribution of parkinsonism as a syndrome. We studied the incidence of parkinsonism and its specific types among residents of Olmsted County, MN, for the period from 1976 through 1990.

METHODS: We used the medical records linkage-system of the Rochester Epidemiology Project to identify all individuals whose records contained documentation of any form of parkinsonism, related neurodegenerative diseases, or tremor of any type. A nurse abstractor screened the records, and, when applicable, a neurologist reviewed them to determine the presence of parkinsonism using specified diagnostic criteria and to define the year of onset.

RESULTS: We found 364 incident cases of parkinsonism: 154 with PD (42%), 72 with drug-induced parkinsonism (20%), 61 unspecified (17%), 51 with parkinsonism in dementia (14%), and 26 with other causes (7%). The average annual incidence rate of parkinsonism (per 100,000 person-years) in the age group 50 to 99 years was 114.7; incidence increased steeply with age from 0.8 in the age group 0 to 29 years to 304.8 in the age group 80 to 99 years. The cumulative incidence of parkinsonism assuming no competing causes of death was 7.5% to age 90 years. PD was the most common type of parkinsonism, followed by parkinsonism in dementia in men and drug-induced parkinsonism in women. Men had higher incidence than women at all ages for all types of parkinsonism except drug-induced.

CONCLUSIONS: Parkinsonism is a common disease among the elderly; its incidence increases steeply with advancing age and is consistently higher in men. The distribution by type changes with age and gender.




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