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Prevalence of Parkinson disease in Singapore

Chinese vs Malays vs Indians

From the Department of Neurology (Drs. L.C.S. Tan, Venketasubramanian, and A.K.Y. Tan) and Clinical Trials and Epidemiology Research Unit (Dr. Krishnamoorthy), National Neuroscience Institute, Singapore; Department of Community, Occupational and Family Medicine (Drs. Hong and Saw), National University of Singapore; and Department of Geriatric Medicine (Drs. Sahadevan and Chin), Tan Tock Seng Hospital, Singapore.

Address correspondence and reprint requests to Dr. Louis C.S. Tan, Department of Neurology, National Neuroscience Institute, 11 Jalan Tan Tock Seng, Singapore 308433, Singapore; e-mail: louis_tan{at}ttsh.com.sg

Objective: To investigate the prevalence of Parkinson disease (PD) in Singapore and compare the rates between Singaporean Chinese, Malays, and Indians.

Methods: A three-phase community-based survey among a disproportionate random sample of 15,000 individuals (9,000 Chinese, 3,000 Malays, 3,000 Indians) aged 50 years and above who live in central Singapore was conducted. In phase 1, trained interviewers conducted a door-to-door survey using a validated 10-question questionnaire. In phase 2, medical specialists examined participants who screened positive to any of the questions. Participants suspected to have PD had their diagnosis confirmed in phase 3 by a movement disorders specialist.

Results: The participation rate was 67% among 22,279 eligible individuals. Forty-six participants with PD were identified of which 16 were newly diagnosed cases. The prevalence rate of PD for those aged 50 and above in Singapore was 0.30% (95% CI: 0.22 to 0.41), age-adjusted to US 1970 census. The prevalence rates increased significantly with age. The age-adjusted prevalence rates among Chinese (0.33%, 95% CI: 0.22 to 0.48), Malays (0.29%, 95% CI: 0.13 to 0.67), and Indians (0.28%, 95% CI: 0.12 to 0.67) were the same (p = 1.0).

Conclusions: The prevalence of PD in Singapore was comparable to that of Western countries. Race-specific rates were also similar to previously reported rates and similar among the three races. Environmental factors may be more important than racially determined genetic factors in the development of PD.

Received October 13, 2003. Accepted in final form February 11, 2004.

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