Early-Onset Parkinsonism and Early-Onset Parkinson’s Disease: A Population-Based Study (2010-2015)

Article type: Research Article

Authors: Camerucci, Emanuele^a | Stang, Cole D.^a | Hajeb, Mania^a | Turcano, Pierpaolo^c | Mullan, Aidan F.^{b; 1} | Martin, Peter^{b; 1} | Ross, Owen A.^{c; d} | Bower, James H.^a | Mielke, Michelle M.^{a; b} | Savica, Rodolfo^{a; *}

Affiliations: [a] Department of Neurology, Mayo Clinic, Rochester, MN, USA | [b] Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA | [c] Department of Neurology, Mayo Clinic, Jacksonville, FL, USA | [d] Department of Clinical Genomics, Mayo Clinic, Jacksonville, FL, USA

Correspondence: [*] Correspondence to: Rodolfo Savica, MD, PhD, Department of Neurology, Mayo Clinic, 200 First Street, SW, Rochester, MN 55905, USA. Tel.: +1 507 284 2120; E-mail: [email protected].

Note: [1] Performed statistical analysis.

Abstract: Background:Early-onset Parkinson’s disease (EOPD), occurring between ages 40 and 55, carries social, societal, and personal consequences and may progress, with fewer comorbidities than typical, later-onset disease. Objective:To examine the incidence and survival of EOPD and other Parkinsonism occurring before age 55 in the population-based cohort of residents in seven Minnesota counties. Methods:A movement-disorder specialist reviewed all the medical records in a 2010–2015 Parkinsonism-incident cohort to confirm diagnosis and subtypes. Results:We identified 27 patients diagnosed at ≤ 50 years with incident Parkinsonism 2010–15:11 (41%) cases of EOPD, 13 (48%) drug-induced Parkinsonism, and 3 (11%) other Parkinsonism; we also identified 69 incident cases of Parkinsonism ≤ 55 years, of which 28 (41%) were EOPD, 28 (41%) DIP, and 13 (19%) other Parkinsonism. Overall incidence for Parkinsonism ≤ 50 years was 1.98/100,000 person-years, and for EOPD was 0.81/100,000 person-years. In patients ≤ 55 years, Parkinsonism incidence was 5.05/100,000 person-years: in EOPD, 2.05/100,000 person-years. Levodopa-induced dyskinesia was present in 45%of EOPD (both ≤ 50 years and ≤ 55 years). Onset of cardinal motor symptoms was proximate to the diagnosis of EOPD, except for impaired postural reflexes, which occurred later in the course of EOPD. Among the 69 Parkinsonism cases ≤ 55 years, 9 (13%; all male) were deceased (only 1 case of EOPD). Men had a higher mortality risk compared to women (p = 0.049). Conclusion:The incidence of EOPD ≤ 50 years was 0.81/100,000 person-years (1.98 in Parkinsonism all type); prior to ≤ 55 years was 2.05/100,000 person-years (5.05 in Parkinsonism all type) with higher incidence in men than women. Men with Parkinsonism, all type, had higher mortality compared to women.

Keywords: Early-onset Parkinson’s disease (EOPD), incident cohort, rochester epidemiology project (REP), prevalence

DOI: 10.3233/JPD-202464

Journal: Journal of Parkinson's Disease, vol. 11, no. 3, pp. 1197-1207, 2021