Dan & Ivan,
Your spirit is great and your efforts much appreciated, but your
numbers are like the fish that got away - they keep growing with
each re-telling. I have been pouring over articles in medical
journals for weeks trying to find any epidemiological surveys that
support even 1 million people with PD, a figure which is commonly
cited.
All the estimates about the numbers of people with PD in this
country are based on just a handful of cases in a few locations.
U.S. Survey Results
Prevalence
__Location________ Date_____Population_____Cases___Per 1000_
| |
| Rochester MN 1955 29,885 56 1.87 |
| Rochester MN 1965 47,797 75 1.57 |
| |
| Baltimore MD 1969 |
| Estimated 2,070,000 1,630 .79 |
| Black |
| Female - - .09 |
| Male - - .31 |
| White - |
| Female - - 1.21 |
| Male - - 1.28 |
| Sample 228 |
| Black - 17 - |
| White - 211 - |
| |
| Copiah Co. MS 1978 23,597 31 1.31 |
| Black 11,666 12 1.03 |
| White 11,931 19 1.59 |
| |
| Manhattan NY 1991 213,302 228 1.07 |
|____________________________________________________________|
The Copiah MS study * includes * 40% previously undiagnosed.
Any extrapolation to the whole country is going to come up with very
imprecise numbers, but the numbers above seem to point to no more
than roughly one-half million diagnosed today, taking population
increases and increased proportion of older people into account.
That's the number the NIH is using. We are going to get a rep in
D.C. for gross over-exaggeration, if we haven't already.
The 1 million already appears to include generous but rough
guesstimates of undiagnosed and pre-symptomatic people. Do
people forget that and add it in again?
Sources
Ellenberg JH, Koller WC, Langston JW. Etiology of Parkinson's
Disease. Marcel Dekker Inc, New York, NY. 1995.
Haerer AF, Anderson DW, Schoenberg BS. Survey of major neurologic
disorders in a biracial United States Population: the Copiah County
Study. So Med J 1987 80(3):339-343.
Kessler II. Epidemiologic studies of Parkinson's disease. 3. A
community-based survey. Am J Epidemiol 1972 Oct 96(4):242-254.
Koller, WC. When does Parkinson's disease begin? Neurology 1992a
42(suppl 4):27- 31.
Koller WC, Langston JW, Hubble JP, Irwin I, Zack M, Golbe L, Forno
L, Ellenberg J, Kurland L, Rutenber AJ, Spencer P, Tanner C, Tetrud
J, Wilcox T, Roman G, Mayeux R, Smith M, Goetz C. Does a long
preclinical period occur in Parkinson's disease? Geriatrics 1991
46(suppl 1):8-16.
Mayeux R, Marder K, Cote LJ, Denaro J, Hemenegildo N, Mejia H, Tang
MX, Lantigua R, Wilder D, Gurland B, et al. The frequency of
idiopathic Parkinson's disease by age, ethnic group, and sex in
northern Manhattan, 1988-1993. Am J Epidemiol, 1995 Oct 15, 142(8)
820-7.
Rajput AH, Offord KP, Beard CM, Kurland LT. Epidemiology of
parkinsonism: incidence, classification, and mortality. Ann Neurol
1984 Sep 16(3):278-282.
Zhang ZX, Roman GC. Worldwide occurrence of Parkinson's disease: an
updated review. Neuroepidemiology 1993 12(4):195-208.
Cheers,
Phil Tompkins
Hoboken 60/9
