背景:帕金森病是第二常见的神经退行性疾病,患病率呈上升趋势。我们的目的是调查帕金森病的患病率,1980年至2023年的时间趋势,以及按地点划分的流行率变化,年龄,性别,调查期间,社会人口统计学指数(SDI),人类发展指数(HDI)和研究特征(样本量,诊断标准,和数据源)。
方法:在本系统综述和荟萃分析中,我们搜索了PubMed,科克伦,WebofScience,Embase,Scopus,和全球健康观察研究报告了从数据库开始到2023年11月1日在普通人群中帕金森病的患病率。我们纳入了研究,如果它们是原始的观察性调查,参与者来自普通人群或基于社区的数据集,并提供了95%CI或足够信息计算95%CI的帕金森病患病率的数值数据。如果研究是在特定人群中进行的,则被排除在外,样本量小于1000,或者是评论文章,病例报告,协议,会议摘要,信件,注释,短通信,海报,和报告。出版物特点(第一作者和出版年份),研究地点(国家,世卫组织区域,SDI,和HDI),调查期间,研究设计,诊断标准,数据源,参与者信息,和患病率数据使用标准表格从文章中提取。两位作者独立评估了资格,并通过与第三作者的讨论解决了差异。我们使用随机效应模型来汇集95%CI的估计值。计算估计的年度百分比变化(EAPC)以评估帕金森病患病率的时间趋势。这项研究在PROSPERO注册,CRD42022364417。
结果:来自37个国家的83项研究符合分析条件,有56项研究提供了所有年龄段的患病率,53项研究报告了特定年龄的患病率,和26项研究提供了所有年龄和特定年龄的患病率。帕金森病的全球汇总患病率为每1000例1·51例(95%CI1·19-1·88),男性(1·54/1000[1·17-1·96])高于女性(1·49/1000[1·12-1·92],p=0·030)。在不同的调查期间,帕金森病的患病率为每1000例0·90例(0·48-1·44;1980-89),每1000例1·38例(1·17-1·61;1990-99),每1000例1·18例(0·77-1·67;2000-09),每1000例3·81例(2·67-5·14;2010-23)。在2004-23年期间,帕金森病的EAPC患病率显着升高(EAPC16·32%[95%CI6·07-26·58],p=0·0040)比1980-2003年期间(5·30%[0·82-9·79],p=0·022)。世卫组织六个区域的患病率存在统计学上的显著差异。患病率随HDI或SDI增加。根据不同的样本量或诊断标准,帕金森病合并患病率存在相当大的差异。患病率也随着年龄的增长而增加,在60岁以上的个体中达到9·34例/1000(7·26-11·67)。
结论:自1980年代以来,帕金森病的全球患病率一直在增加,在过去的二十年中,增长更为明显。在HDI或SDI较高的国家,帕金森病的患病率较高。有必要开展更多高质量的帕金森病流行病学研究,特别是在低SDI国家。
背景:国家自然科学基金.
■有关摘要的中文翻译,请参见补充材料部分。
BACKGROUND: Parkinson\'s disease is the second most common neurodegenerative disorder, exhibiting an upward trend in prevalence. We aimed to investigate the prevalence of Parkinson\'s disease, temporal trends between 1980 and 2023, and variations in prevalence by location, age, sex, survey period, sociodemographic index (SDI), human development index (HDI), and study characteristics (sample size, diagnostic criteria, and data source).
METHODS: In this systematic review and meta-analysis we searched PubMed, Cochrane, Web of Science, Embase, Scopus, and Global Health for observational studies that reported Parkinson\'s disease prevalence in the general population from database inception to Nov 1, 2023. We included studies if they were original observational investigations, had participants from the general population or community-based datasets, and provided numerical data on the prevalence of Parkinson\'s disease either with 95% CIs or with sufficient information to calculate 95% CIs. Studies were excluded if they were conducted in a specific population, had a sample size smaller than 1000, or were review articles, case reports, protocols, meeting abstracts, letters, comments, short communications, posters, and reports. The publication characteristics (first author and publication year), study location (countries, WHO regions, SDI, and HDI), survey period, study design, diagnostic criteria, data source, participant information, and prevalence data were extracted from articles using a standard form. Two authors independently evaluated eligibility, and discrepancies were resolved through discussion with the third author. We used random effect models to pool estimates with 95% CIs. Estimated annual percentage change (EAPC) was calculated to assess the temporal trend in prevalence of Parkinson\'s disease. The study was registered with PROSPERO, CRD42022364417.
RESULTS: 83 studies from 37 countries were eligible for analysis, with 56 studies providing all-age prevalence, 53 studies reporting age-specific prevalence, and 26 studies providing both all-age and age-specific prevalence. Global pooled prevalence of Parkinson\'s disease was 1·51 cases per 1000 (95% CI 1·19-1·88), which was higher in males (1·54 cases per 1000 [1·17-1·96]) than in females (1·49 cases per 1000 [1·12-1·92], p=0·030). During different survey periods, the prevalence of Parkinson\'s disease was 0·90 cases per 1000 (0·48-1·44; 1980-89), 1·38 cases per 1000 (1·17-1·61; 1990-99), 1·18 cases per 1000 (0·77-1·67; 2000-09), and 3·81 cases per 1000 (2·67-5·14; 2010-23). The EAPC of Parkinson\'s disease prevalence was significantly higher in the period of 2004-23 (EAPC 16·32% [95% CI 6·07-26·58], p=0·0040) than in the period of 1980-2003 (5·30% [0·82-9·79], p=0·022). Statistically significant disparities in prevalence were observed across six WHO regions. Prevalence increased with HDI or SDI. Considerable variations were observed in the pooled prevalence of Parkinson\'s disease based on different sample sizes or diagnostic criteria. Prevalence also increased with age, reaching 9·34 cases per 1000 (7·26-11·67) among individuals older than 60 years.
CONCLUSIONS: The global prevalence of Parkinson\'s disease has been increasing since the 1980s, with a more pronounced rise in the past two decades. The prevalence of Parkinson\'s disease is higher in countries with higher HDI or SDI. It is necessary to conduct more high-quality epidemiological studies on Parkinson\'s disease, especially in low SDI countries.
BACKGROUND: National Nature Science Foundation of
China.
UNASSIGNED: For the Chinese translation of the abstract see Supplementary Materials section.