Current Zi study on the incidence of Parkinson's disease 2013-2019 published
26.08.2022 10:32
Despite the dynamic aging of the population, the frequency of new Parkinson's diagnoses in medical billing data in Germany fell by up to 30 percent between 2013 and 2019. While the average incidence across all age groups in 2013 was 168 per 100,000 members of the statutory health insurance (GKV) aged 50 and over, this value fell to 122 by 2019.
Three case definitions were summarized, which were used to check the robustness of the trends identified. During the same period, the number of new cases of ideopathic Parkinson's syndrome (IPS) diagnosed by contract doctors nationwide fell from just under 130,000 to just over 112,000 on average across the three case definitions. The continuous decline in the annual incidence of diagnosis since 2013 has been noted nationwide in all age groups over 50, in both gender groups and nationally throughout Germany.
These are the central results of a current care atlas study by the Central Institute for Statutory Health Insurance (Zi) on “incidence trends of diagnosed ideopathic Parkinson's syndrome in the years 2013 to 2019”. “Parkinson's disease is associated with a variety of diseases, particularly those typical of old age. This draws attention to the complexity of medical care for this particular group of patients. The treatment requires intensive cooperation and communication between the general practitioners, specialists and health professionals involved. It is noteworthy that the incidences continue to decline, even in rural areas. In previous years, the number of cases there was always higher than in urban areas,” said Zi CEO Dr. Dominik von Stillfried. One can currently only speculate about the reasons for the decline in the incidence of Parkinson's disease; the examined statutory health insurance billing data does not provide any further evidence for this, continued von Stillfried.
“Conceivable causal connections between the use of agricultural chemicals and the risk of developing IPS have been the focus of scientific debate for some time, given the increased risk of disease often found in rural areas. Whether changes in the use of pesticides pose a lower risk of triggering secondary diseases such as Parkinson's and could be partly responsible for the decline in the number of new cases still needs to be further scientifically investigated and validated," emphasized the Zi CEO.
Idiopathic Parkinson's syndrome (IPS) is a neurodegenerative disease that occurs almost exclusively in old age and is characterized by a progressive loss of neurons in the central nervous system. The cardinal symptoms of PD include movement disorders such as delayed initiation of movements (akinesia), slowing of movements (bradykinesia), muscle tension (rigor), muscle tremors (tremor) and disruption of upright posture (postural instability). Common comorbidities include dementia and a range of psychological conditions, particularly depression. PD is by far the most common manifestation of Parkinson's disease and can be distinguished from non-idiopathic or secondary Parkinson's syndrome. In addition to increased exposure to agricultural chemicals, consumption of dairy products, hormone replacement therapy, type 2 diabetes mellitus, but also previous mental illnesses including depression, bipolar disorders and mood swings fall into the group of possible non-genetic or not exclusively genetic risk factors.
The basis for the statistical analysis is the nationwide pseudonymized, cross-health insurance provider billing data in accordance with Section 295 SGB V and medication prescription data in accordance with Section 300 Paragraph 2 SGB V from 2013 to 2019 for patients aged 50 and over. The frequency of new occurrences of PD was recorded annually in the period 2013 to 2019 in cohorts of statutory health insurance patients who were observed for a minimum period of four years. In addition to a primary case definition, two further case definitions with variations of the minimum requirements for the utilization patterns of incident IPS cases were used to test the robustness of the incidence trends found at the federal level.
Dammertz L, Kohring C, Heuer J, Akmatov MK, Bätzing J, Holstiege J. Incidence trends of diagnosed idiopathic Parkinson's syndrome in the years 2013 to 2019. Central Institute for Statutory Health Insurance in Germany (Zi). Supply Atlas Report No. 22/06. Berlin 2022. > https://doi.org/10.20364/VA-22.06