Parkinson (German Edition)

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Die Parkinson Krankheit: Grundlagen, Klinik, Therapie 2001

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Die Parkinson Krankheit: Grundlagen, Klinik, Therapie

To increase the number of PD cases in our analysis sample, we combined the two time periods. For calculating the standardized prevalence, we used the average age distribution for both sexes combined of and in Germany. For calculating the standardized incidence rate, we used the average age distribution for both sexes combined of and in Germany.

The study is based on anonymized administrative claims data that never involved patients directly. Individual patients cannot be identified, and the analyses presented do not affect patients whose anonymized records were used. These validation strategies were based on the type of physician, repeated diagnoses, and medication. AOK claims data , Secondly, we excluded persons from our prevalent or incident cases in case the last diagnosis in our longitudinal data was atypical parkinsonism.

Finally, we developed eight validation strategies by combining diagnoses from different medical sectors using the following criteria: For the sake of brevity, however, we shall omit the latter qualification. The level and the age profile are comparable to those of previous international studies. Then, they declined mildly and reached a level of SIa: The mean age of PD onset was While incidence rates vary considerably between studies, our estimates are at the higher end.

Thereafter, the increase in new PD cases slowed down.

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Regarding sex, men had a higher standardized incidence rate SIa: Until now, health claims data have not been widely used in the field of epidemiological research in Germany, and to our knowledge, this is the first study that has investigated PD using this type of data. Wermuth, Lassen 24 evaluated PD diagnoses from Danish medical records and found that The stricter the strategy see strategy SIIc in Figure S1 , the more patients we exclude from our analysis and consequently the lower the prevalence became, particularly for the oldest old.

Die Parkinson-Krankheit: Grundlagen, Klinik, Therapie (German Edition)

One may argue that at advanced ages patients with PD may be prescribed PD medication to a lesser extent than at younger ages, probably due to negative side effects or adverse interactions. Compared to the other studies, our higher incidence rates may be explained by 1 the inclusion of the institutionalized population, which is missing in most other studies.

Michael Palin on Parkinson 1982

Thus, incidence rates of PD which start rising strongly at higher ages may only marginally affected; 3 the uncertainty of the diagnostic criteria of PD in claims data where more than half of all diagnoses were made by physicians who are not trained to detect PD. In contrast to our approach, this French study required a PD diagnosis to be confirmed by two different physicians. Age seems to be one of the main factors for the occurrence of PD.

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Some studies, including our investigation, found a decline in incidence rates for the oldest old, 14 , 15 , 16 , 17 , 18 and others did not. The decline might be partly a consequence of diagnostic uncertainty. For instance, typical extrapyramidal signs of PD as tremors are often associated with Alzheimer's disease, leading to misdiagnoses. We found sex differences in the occurrence of PD which are consistent with previous studies.

This study has several limitations. AOK data display only a part of the German population resulting in a lack of representativeness. To give a more representative picture of PD in Germany, data from other insurances would be needed. Currently, public health insurances cover about 70 million persons, whereby the AOK represents the largest part 25 million insured persons. The access to health claims data is very restricted because of the fact that the data are a sensible data source and have ethical restrictions imposed due to concerns regarding privacy.

Furthermore, the comparison of death rates from the AOK and the German population indicates marginal differences Table S4. Routine claims data in general are primarily compiled for billing purposes in the healthcare sector and not for epidemiological analyses, meaning that coding errors are possible. We took this issue into account by performing internal validation procedures. Despite these procedures, wrong diagnoses may stem from the fact that some patients were diagnosed by general practitioners and not only by specialists.

Parkinson’s disease - English translation in German - Langenscheidt dictionary English-German

An external validation of diagnoses is not possible. Furthermore, financial incentives may lead to false diagnoses, resulting in excessive numbers in routine claims data. One advantage of using AOK data is the large size of the study population on a national basis; a second is the inclusion of the institutionalized population. Our results emphasize the present relevance of PD in Germany. Regarding aging populations worldwide, the consequences at the individual and society levels will be intensified.

Thus, it is essential to be aware of the recent and reliable epidemiological data of PD to obtain needs assessments and cost calculations, and to offer adequate care services. For a better understanding of PD in the future, it might be helpful to conduct investigations concerning potential risk factors and gather information about changes of PD over time.

Nerius have nothing to disclose.

Parkinson (German Edition) Parkinson (German Edition)
Parkinson (German Edition) Parkinson (German Edition)
Parkinson (German Edition) Parkinson (German Edition)
Parkinson (German Edition) Parkinson (German Edition)
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