Prevalence of Parkinson Disease in Italy: a systematic review and meta-analysis
Main Article Content
Parkinson’s disease, Parkinsonism, prevalence, epidemiology, occurrence
Introduction. Parkinson's disease (PD) is a common disease of unknown etiology. Even though accurate information on the epidemiology of PD is critical for defining appropriate health policies, epidemiological data on Parkinson’s disease (PD) in Italy are often defined as scant or conflicting. Our study attempted to provide an overview on the prevalence of (PD) by means of a systematic review and metanalysis of existing data.
Material and methods. We searched into two different databases (PubMed and EMBASE), focusing on studies reporting the prevalence of PD in Italy. Data were extracted using a standardized assessment form, and results of such analyses were systematically reported, summarized and compared.
Results. A total of 16 studies were eventually included in the analyses, with a prevalence rate of 193.7/100,000. Available reports were heterogeneous both in design and in eventual figures, and also prevalence estimates were affected by substantial heterogeneity. Interestingly, prevalence rates ranged from 37.8/100,000 inhabitants in subjects aged 0 to 64 years, to 578.7 in age group 65 to 75 years, and 1235.7 in age group 75 years or older. PD was significantly associated with male sex, but only in older age groups (i.e. Odds Ratio, OR 1.37 95%CI 1.22-1.53, and OR 1.31, 95%CI 1.21-1.42 for age groups 65-74 years and 75 years or more, respectively).
Discussion and conclusion. While the observed variations in prevalence rates may result from environmental or genetic factors, differences in methodologies for case ascertainment and diagnostic criteria may have significantly affected our estimates. As a consequence, the comparability of existing studies is limited.
2. De Lau LML, Breteler MMB. The epidemiology of Parkinson’s disease. Lancet Neurol. 2006;5:525–35. DOI: 10.1016/S1474-4422(06)70471-9
3. Von Campenhausen S, Bornschein B, Wick R, Bötzel K, Sampaio C, Poewe W, et al. Prevalence and incidence of Parkinson’s disease in Europe. Eur Neuropsychopharmacol. 2005;15(4):473–90. DOI: 10.1016/j.euroneuro.2005.04.007
4. Ball N, Teo W-P, Chandra S, Chapman J. Parkinson’s Disease and the Environment. Front Neurol. 2019;10:218. DOI: 10.3389/fneur.2019.00218
5. Elbaz A, Carcaillon L, Kab S, Moisan F. The scientific bases to consider Parkinson’s disease an occupational disease in agriculture professionals exposed to pesticides in France. J Epidemiol Community Heal. 2014;70(4):319–21. DOI: 10.1136/jech-2015-205455
6. Vlaar T, Kab S, Schwaab Y, Fréry N, Elbaz A, Moisan F. Association of Parkinson’s disease with industry sectors: a French nationwide incidence study. Eur J Epidemiol. 2018;33(11):1101–11. DOI: 10.1007/s10654-018-0399-3
7. Moisan F, Spinosi J, Delabre L, Gourlet V, Mazurie JL, Bénatru I, et al. Association of parkinson’s disease and its subtypes with agricultural pesticide exposures in men: A case-control study in France. Environ Health Perspect. 2015;123(11):1123–9. DOI: 10.1289/ehp.1307970
8. Signorelli C, Riccò M, Vinceti M. [Waste incinerator and human health: a state-of-the-art review]. Ann Ig 2008;20(3),251-277
9. Tolosa E, Wenning G, Poewe W. The diagnosis of Parkinson’s disease. Lancet Neurol. 2006;5(1):75–86. DOI: 10.1016/S1474-4422(05)70285-4
10. Ascherio A, Schwarzschild MA. The epidemiology of Parkinson’s disease: risk factors and prevention. Lancet Neurol. 2016;15(12):1257–72. DOI: 10.1016/S1474-4422(16)30230-7
11. Tysnes OB, Storstein A. Epidemiology of Parkinson’s disease. J Neural Transm. 2017;124(8):901–5. DOI: 10.1007/s00702-017-1686-y
12. Wirdefeldt K, Adami HO, Cole P, Trichopoulos D, Mandel J. Epidemiology and etiology of Parkinson’s disease: A review of the evidence. Eur J Epidemiol. 2011;26(S1):S1-S58. DOI: 10.1007/s10654-011-9581-6
13. Moher D, Liberati A, Tetzlaff J, Altman DG, Altman D, Antes G, et al. Preferred reporting items for systematic reviews and meta-analyses: The PRISMA statement. PLoS Med. 2009;6(7):e1000097. DOI: 10.1371/journal.pmed.1000097
14. Rosati G, Granieri E, Pinna L, Aiello I, De Bastiani P, Tola R, et al. Parkinson’s Disease. Prevalence and Incidence in the Province of Sassari, North Sardinia. Acta Neurol. 1978;33(3):201–7.
15. Rosati G, Granieri E, Pinna L, Devoto MC. The Frequency of Parkinson’s Disease in the Province of Nuoro (Sardinia). Acta Neurol. 1979;1(4):303–8.
16. Tominz R, Marin L, Mezzarobba S. [Estimate of the Prevalence of Parkinson's Disease by Using Electronic Health Archives]. Recenti Prog Med. 2015;106(2):97–102. DOI: 10.1701/1790.19496
17. Pupillo E, Cricelli C, Mazzoleni F, Cricelli I, Pasqua A, Pecchioli S, et al. Epidemiology of Parkinson’s Disease: A Population-Based Study in Primary Care in Italy. Neuroepidemiology. 2016;47(1):38–45. DOI: 10.1159/000448402
18. Baldacci F, Policardo L, Rossi S, Ulivelli M, Ramat S, Grassi E, et al. Reliability of administrative data for the identification of Parkinson’s disease cohorts. Neurol Sci. 2015 May 1;36(5):783–6. DOI: 10.1007/s10072-015-2062-z
19. Malaguti MC, Vanacore N, Ferrari S, Piffer S, Pertile R, Roni R, et al. An unexpected higher prevalence of Parkinson’s disease in females than in males in the province of Trento (Italy): a clues for the etiopathogenesi. Park Relat Disord. 2016;22:e29. DOI: 10.1016/j.parkreldis.2015.10.025
20. Valent F, Devigili G, Rinaldo S, Del Zotto S, Tullio A, Eleopra R. The epidemiology of Parkinson’s disease in the Italian region Friuli Venezia Giulia: a population-based study with administrative data. Neurol Sci. 2018;39(4):699–704. DOI: 10.1007/s10072-018-3273-x
21. Eusebi P, Franchini D, De Giorgi M, Abraha I, Montedori A, Casucci P, et al. Incidence and prevalence of Parkinson’s disease in the Italian region of Umbria: a population-based study using healthcare administrative databases. Neurol Sci. 2019 Aug 1;40(8):1709–12. DOI: 10.1007/s10072-019-03872-w
22. Rosati G, Granieri E, Pinna L, Aiello I, Tola R, De Bastiani P, et al. The Risk of Parkinson Disease in Mediterranean People. Neurology. 1980;30(3):250–5. DOI: 10.1212/wnl.30.3.250
23. D’Alessandro R, GamberiniG, Granieri E, Benassi G, Naccarato S, Manzaroli D. Prevalence of Parkinson’s Disease in the Republic of San Marino. Neurology. 1987;37(10):1679–82. DOI: 10.1212/wnl.37.10.1679
24. Morgante L, Rocca WA, Di Rosa AE, De DP, Grigoletto F, Meneghini F, et al. Prevalence of Parkinson’s disease and other types of parkinsonism: a door-to-door survey in three Sicilian municipalities. The Sicilian Neuro-Epidemiologic Study (SNES) Group. Neurology. 1992;42(10):1901–7. DOI: 10.1212/wnl.42.10.1901
25. Beghi E, Monticelli ML, Sessa A, Simone P. The prevalence of parkinsonism in Italy: An epidemiological survey of the disease in general practice. Mov Disord. 1994;9(4):403–8. DOI: 10.1002/mds.870090405
26. Chiò A, Magnani C, Schiffer D. Comparison of Tracer Methodology and Clinical Ascertainment of Cases. Mov Disord. 1998;13(3):40. DOI: 10.1002/mds.870130305
27. Totaro R, Marini C, Pistoia F, Sacco S, Russo T, Carolei A. Prevalence of Parkinson’s disease in the L’Aquila district, central Italy. Acta Neurol Scand. 2005;112(1):24–8. DOI: 10.1111/j.1600-0404.2005.00426.x
28. Morgante L, Nicoletti A, Epifanio A, Contrafatto D, Savica R, Lanzafame S, et al. Prevalence of Parkinson’s disease and other types of parkinsonism in the Aeolian Archipelago, Sicily. Park Relat Disord. 2008;14(7):572–5. DOI: 10.1016/j.parkreldis.2007.11.010
29. Zucchi A, Ferraro B, Imbalzano G, Brembilla G, Sileo C. Economia e Management Il network Parkinson Bergamo . organizzativo-assistenziali a rete Economia e Management. Sanità Pubblica e Priv. 2011;6:43–52.
30. Squitieri F, Griguoli A, Capelli G, Porcellini A, D’Alessio B. Epidemiology of Huntington disease: First post-HTT gene analysis of prevalence in Italy. Clin Genet 2016;89(3):367–70. DOI: 10.1111/cge.12574
31. Frontali M, Malaspina P, Rossi C, Jacopini AG, Vivona G, Pergola MS, et al. Epidemiological and linkage studies on Huntington’s disease in Italy. Hum Genet 1990;85(2):165–70. DOI: 10.1007/bf00193190
32. Lucchini RG, Albini E, Benedetti L, Borghesi S, Coccaglio R, Malara EC, et al. High Prevalence of Parkinsonian Disorders Associated to Manganese Exposure in the Vicinities of Ferroalloy Industries. Am J Ind Med. 2007;50(11):788–800. DOI: 10.1002/ajim.20494
33. Riccò M, Bragazzi NL, Vezzosi L, Balzarini F, Colucci E, Veronesi L, et al. Knowledge , Attitudes , and Practices on Tick-Borne Human Diseases and Tick-Borne Encephalitis Vaccine among Farmers from North-Eastern Italy ( 2017 ) J Agromedicine 2020;25(1):73–85. DOI: 10.1080/1059924X.2019.1659204
34. Riccò M, Cattani S, Veronesi L, Colucci ME. Knowledge, attitudes, beliefs and practices of construction workers towards tetanus vaccine in northern Italy. Ind Health [Internet]. 2016;54(6):554-563 DOI: 10.2486/indhealth.2015-0249
35. Riccò M. Air temperature exposure and agricultural occupational injuries in the autonomous province of trento (2000-2013, north-eastern Italy). Int J Occup Med Environ Health. 2018;31(3):317-331. DOI: 10.13075/ijomeh.1896.01114
36. Riccò M, Vezzosi L, Mezzoiuso AG. Occupational Eye Injury in the agricultural settings: a retrospective study from North-Eastern Italy. Acta Biomed 2020;90(4):457-467. DOI: 10.23750/abm.v90i4.7602
37. Kab S, Spinosi J, Chaperon L, Dugravot A, Singh-Manoux A, Moisan F, et al. Agricultural activities and the incidence of Parkinson’s disease in the general French population. Eur J Epidemiol. 2017;32(3):203–16. DOI: 10.1007/s10654-017-0229-z
38. Riccò M, Vezzosi L, Bragazzi NL, Balzarini F. Heat-Related Illnesses among Pesticide Applicators in North-Eastern Italy (2017). J Agromedicine. 2020;25(1):52-64 DOI: 10.1080/1059924X.2019.1606745
39. Riccò M, Vezzosi L, Gualerzi G. Health and Safety of Pesticide Applicators in a high income agricultural setting: a knowledge, attitude, practice, and toxicity study from North-Eastern Italy. J PREV MED HYG. 2018;59(3):E200-E211. DOI: 10.15167/2421-4248/jpmh2018.59.3.934
40. Riccò M, Cattani S, Signorelli C. Personal risk factors for carpal tunnel syndrome in female visual display unit workers. Int J Occup Med Environ Health. 2016;29(6):927-936 10.13075/ijomeh.1896.00781 41.
41. Ricco M, Signorelli C. Personal and occupational risk factors for carpal tunnel syndrome in meat processing industry workers in northern italy. Med Pr 2017;68(2):199-209. DOI: 10.13075/mp.5893.00605
42. Petit A, Bodin J, Delarue A, Escatha AD, Fouquet N, Roquelaure Y. Risk factors for episodic neck pain in workers : a 5-year prospective study of a general working population. Int Arch Occup Environ Health. 2018;91(3):251-261. DOI: 10.1007/s00420-017-1272-5
43. Roquelaure Y, Bodin J, Ha C, le Manac’h AP, Descatha A, Chastang JF, et al. Personal, biomechanical, and psychosocial risk factors for rotator cuff syndrome in a working population. Scand J Work Environ Heal. 2011;37(6):502–11. DOI: 10.5271/sjweh.3179
44. Govoni V, Granieri E, Tola MR, Casetta I, Monetti VC, Fainardi E, et al. Prevalence of anti-parkinson drugs’ use in Ferrara, Northern Italy, 1988. Acta Neurol Scand. 1994;31:433–8. DOI: 10.1111/j.1600-0404.1994.tb02662.x
45. Granieri E, Carreras M, Casetta I, Govoni V, Tola MR, Paolino E, et al. Parkinson ’ s Disease in Ferrara, Italy, 1967 through 1987. Arch Neurol. 1991;48:854–7. DOI: 10.1001/archneur.1991.00530200096026