Comparative Analysis of the Incidence, Prevalence, and Survival of 8 Types of Parkinsonism in a Population-Based Study with 367 Million Person Years of Observation over 21 Years.

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BackgroundFindings are contradictory regarding changes in the incidence and prevalence of Parkinson's disease (PD) over time; data for other parkinsonian disorders are rare.ObjectivesTo analyze temporal trends in the incidence and prevalence of eight parkinsonisms (PD, MSA, PSP, CBS, DLB, vascular parkinsonism, drug-induced parkinsonism, and other secondary parkinsonism) from 2003 to 2023, assess their survival, and define sociodemographic factors associated with PD.MethodsAnalysis of primary and linked secondary care data in a population-based UK observational study using multivariable regression models and Kaplan-Meier survival methods.ResultsAge- and sex-adjusted incidence and prevalence rates of rarer parkinsonisms increased substantially pre-Covid-19, while adjusted PD rates declined then stabilized. From 2003 to 2010, the incidence of rarer parkinsonisms increased annually by 13.8% (95% CI 13.5, 14.0%), while PD incidence declined annually by 4.7% (4.5, 4.9%). From 2011 to 2019, the incidence of rarer parkinsonisms increased annually by 3.2% (2.9, 3.5%) while PD incidence changed by -0.3% (-0.5, 0.0%) annually. Prevalence fell for PD from 2003 to 2019 by 0.6% annually (0.6, 0.7%), but increased for other parkinsonisms by 7.1% (6.8, 7.3%) before slowing to 3.3% (3.1, 3.5%) annually. Of the degenerative parkinsonisms, 5-year survival was best for PD at 64.2% (64.0, 64.4%) and worst for PSP at 30.5% (29.3, 31.8%). Adjusted PD incidence was 43% lower (16, 62%) in individuals of African/Caribbean ethnicity, but similar for Asian and White ethnicities.ConclusionsIncreasing diagnosis of rarer parkinsonisms has contributed to changing temporal trends for PD. Ethnic variations for PD justify further exploration.

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