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Thank you, Jim Slattery. A second question, perhaps more along the lines of your personal expertise, has to do with epidemiology itself. I recently saw a mention somewhere that there is no PD in really old people; it is understandable that really old people would tend to be really healthy (or lucky/unlucky depending on a personal viewpoint) individuals. We often hear that PD does not shorten lifespan itself, it only makes life hell --but it all ends one day. Does there seem to be an age that is the 'end' time period in PD? (A report mentioned that less suicide is reported among PD patients than the general population.) This also likely to be complicated with data gathering issues... Ansa Ojanlatva, PhD, CHES (ret.) Docent, Health and Sexuality Education Authorized Sexuality Educator and Sexual Health Promotor (NACS), Authorized in Sexual Science (NACS) Sanitas 3rd floor Lemminkäisenkatu 1 20014 University of Turku, Finland mobile +358-400-823 816 tel +358-2-333 8515 fax +358-2-333 8439 Please use the mobile phone number for calling. ----- Original Message ----- From: Jim Slattery <[log in to unmask]> Date: Monday, April 6, 2009 9:35 am Subject: Re: My information To: [log in to unmask] > > out of curiosity, have you worked with medical geography issues in > PD > > epidemiology? If so, is there something we should know about the > > distribution of this condition? > > Hello Ansa, > > No, there do not seem to be any geographical issues in PD > epidemiology, at > least, not in Australia. My colleague and collaborator, Dr Simon > Hammond MB > BS (Lond) PhD (Syd) FRCP(UK) FRACP, had found a corollary with > temperature > gradations related to latitude in his definitive work on Multiple > Sclerosis, > where prevalence appeared to increase with distance from the equator. > > However, in Parkinson's Disease, where clusters of cases occurred, any > > apparent geological variations were filtered out by comparative > analysis > between quintiles by age and sex of actual Parkinson's sufferers, and > > matching quintiles of actual general population as noted in census > data for > the comparative period, any clustering became apparent at variations > due to > sociological aspects, rather than geographical ones. > > For example, where a raw data set for the Kimberley/Pilbara areas of > Western > Australia appeared to indicate an unusually low prevalence of PD, the > > adjusted data revealed that there was an anomaly in the population > statistics, brought about by extensive migration of younger people to > these > areas to work in the mining industry. Similarly, there appeared to be > an > abnormally enhanced prevalence of PD in the Perth Hills district of > Western > Australia, this anomaly resolved, on examination, to be due to > extensive > migration of elderly people - those most likely to have PD - from > other > areas of the state to retire in the pleasant surroundings of this district. > > It became rapidly apparent, the longer this study continued, that > using > Standard Population data for the age comparison, and using estimated > prevalence for the PD sufferers component, gave results that were much > in > variance with that data obtained from Government medical databases, > and > census material. It turned out that the prevalence as used in many > papers on > PD, could be shown to be vastly underated, with the official > Australian-wide > prevalence being in the order of 30,000 whereas our study showed the > more > accurate figure to be in the order of 85,000. > > An analysis of some 2,000 papers on PD prevalence show similar > discrepancies, mostly bought about by methodology that was, to say the > > least, suspect. > > Sorry for such a long-winded answer, but as you can see, there is no > simple > answer to what is s very complex question> the one simple-seeming > answer > that I can give is that there were several anomalous clusters of > increased > prevalence, of statistical significance, whose only common factor was > that > they were areas in which the local drinking water supply was sourced > form > limestone predominate areas. > > Jim Slatttery > > ---------------------------------------------------------------------- > To sign-off Parkinsn send a message to: mailto:[log in to unmask] > In the body of the message put: signoff parkinsn ---------------------------------------------------------------------- To sign-off Parkinsn send a message to: mailto:[log in to unmask] In the body of the message put: signoff parkinsn