Incidence and Lifetime Risk of Parkinson’s Disease in Advanced Age: Review and Estimates from the United States

Jane A. Driver and Tobias Kurth. Incidence and Lifetime Risk of Parkinson’s Disease in Advanced Age: Review and Estimates from the United States. The European Neurological Journal., September 2009; 1(1): 19-24


Jane A. Driver¹ and Tobias Kurth²

Affiliations: ¹Divisions of Aging and ²Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA; ³Department of Epidemiology, Harvard School of Public Health, Boston, MA, USA; ⁴INSERM Unit 708—Neuroepidemiology, Paris, France; ⁵Faculty of Medicine, Pierre et Marie Curie University, Paris, France

Submission date: 27th June 2009, Revision date: 15th July 2009, Acceptance date: 5th August 2009


ABSTRACT
Age is the strongest known risk factor for Parkinson’s disease (PD). However, its incidence after the age of 80 years is controversial. We examined existing data on the incidence of PD in advanced age, with a focus on studies from the United States. The evidence suggests that PD incidence in men continues to increase in an age-dependent fashion after age 80 years, at least until age 90 years. Data in women are insufficient to draw any conclusions.

Lifetime risk is a helpful way of summarizing the absolute risk of ever developing a disease during one’s remaining lifetime. It reflects the true risk of disease in an elderly population because it adjusts for competing risks of death. We discuss the utility of the lifetime risk statistic and present data from the Physicians’ Health Study. In this cohort of initially healthy and longlived men, the lifetime risk of PD at age 45 years was 1 in 15, higher than the risk of lung, colorectal, and bladder cancer. While the remaining lifetime risk of PD declined slightly with increasing age, it remained substantial at age 80 years, with a risk of 1 in 21. As life expectancy continues to increase worldwide, the burden of PD will grow dramatically. More estimates of the lifetime risk of PD in general populations are needed.

Keywords: Parkinson’s disease, incidence, lifetime risk, cohort study, review

Correspondence: Jane A. Driver, Division of Aging, Brigham and Women’s Hospital, 1620 Tremont Street, Boston, MA 02120, USA. Tel: +1-617-525-7946; fax: +1-617-525-7739; e-mail: jdriver@partners.org