Parkinson disease male-to-female ratios increase with age: French nationwide study and meta-analysis
Identifieur interne : 001906 ( Ncbi/Curation ); précédent : 001905; suivant : 001907Parkinson disease male-to-female ratios increase with age: French nationwide study and meta-analysis
Auteurs : Frédéric Moisan [France] ; Sofiane Kab [France] ; Fatima Mohamed [France] ; Marianne Canonico [France] ; Morgane Le Guern [France] ; Cécile Quintin [France] ; Laure Carcaillon [France] ; Javier Nicolau [France] ; Nicolas Duport [France] ; Archana Singh-Manoux [France] ; Marjorie Boussac-Zarebska [France] ; Alexis Elbaz [France]Source :
- Journal of Neurology, Neurosurgery, and Psychiatry [ 0022-3050 ] ; 2015.
Abstract
Parkinson’s disease (PD) is 1.5 times more frequent in men than women. Whether age modifies this ratio is unclear. We examined whether male-to-female (M–F) ratios change with age through a French nationwide prevalence/incidence study (2010) and a meta-analysis of incidence studies.
We used French national drug claims databases to identify PD cases using a validated algorithm. We computed M–F prevalence/incidence ratios overall and by age using Poisson regression. Ratios were regressed on age to estimate their annual change. We identified all PD incidence studies with age/sex-specific data, and performed a meta-analysis of M–F ratios.
On the basis of 149 672 prevalent (50% women) and 25 438 incident (49% women) cases, age-standardised rates were higher in men (prevalence=2.865/1000; incidence=0.490/1000 person-years) than women (prevalence=1.934/1000; incidence=0.328/1000 person-years). The overall M–F ratio was 1.48 for prevalence and 1.49 for incidence. Prevalence and incidence M–F ratios increased by 0.05 and 0.14, respectively, per 10 years of age. Incidence was similar in men and women under 50 years (M–F ratio <1.2, p>0.20), and over 1.6 (p<0.001) times higher in men than women above 80 years (p trend <0.001). A meta-analysis of 22 incidence studies (14 126 cases, 46% women) confirmed that M– F ratios increased with age (0.26 per 10 years, p trend=0.005).
Age-increasing M–F ratios suggest that PD aetiology changes with age. Sex-related risk/protective factors may play a different role across the continuum of age at onset. This finding may inform aetiological PD research.
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DOI: 10.1136/jnnp-2015-312283
PubMed: 26701996
PubMed Central: 5013115
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sortKey="Kab, Sofiane" sort="Kab, Sofiane" uniqKey="Kab S" first="Sofiane" last="Kab">Sofiane Kab</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Département santé travail</addr-line>,<institution>Institut de veille sanitaire (InVS)</institution>,<addr-line>Saint-Maurice</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Epidemiology of ageing and age related diseases</addr-line>,<institution>INSERM, Centre for Research in Epidemiology and Population Health, U1018</institution>,<addr-line>Villejuif</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>University Paris-Sud, UMRS 1018</institution>,<addr-line>Villejuif</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Mohamed, Fatima" sort="Mohamed, Fatima" uniqKey="Mohamed F" first="Fatima" last="Mohamed">Fatima Mohamed</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Epidemiology of ageing and age related diseases</addr-line>,<institution>INSERM, Centre for Research in Epidemiology and Population Health, U1018</institution>,<addr-line>Villejuif</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>University Paris-Sud, UMRS 1018</institution>,<addr-line>Villejuif</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Canonico, Marianne" sort="Canonico, Marianne" uniqKey="Canonico M" first="Marianne" last="Canonico">Marianne Canonico</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Epidemiology of ageing and age related diseases</addr-line>,<institution>INSERM, Centre for Research in Epidemiology and Population Health, U1018</institution>,<addr-line>Villejuif</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>University Paris-Sud, UMRS 1018</institution>,<addr-line>Villejuif</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Le Guern, Morgane" sort="Le Guern, Morgane" uniqKey="Le Guern M" first="Morgane" last="Le Guern">Morgane Le Guern</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Département santé travail</addr-line>,<institution>Institut de veille sanitaire (InVS)</institution>,<addr-line>Saint-Maurice</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Quintin, Cecile" sort="Quintin, Cecile" uniqKey="Quintin C" first="Cécile" last="Quintin">Cécile Quintin</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Département des maladies chroniques et des traumatismes</addr-line>,<institution>Institut de veille sanitaire (InVS)</institution>,<addr-line>Saint-Maurice</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Carcaillon, Laure" sort="Carcaillon, Laure" uniqKey="Carcaillon L" first="Laure" last="Carcaillon">Laure Carcaillon</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Département des maladies chroniques et des traumatismes</addr-line>,<institution>Institut de veille sanitaire (InVS)</institution>,<addr-line>Saint-Maurice</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Nicolau, Javier" sort="Nicolau, Javier" uniqKey="Nicolau J" first="Javier" last="Nicolau">Javier Nicolau</name><affiliation wicri:level="1"><nlm:aff id="af5"><institution>Institut de veille sanitaire (InVS), Direction scientifique et de la qualité</institution>,<addr-line>Saint-Maurice</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Duport, Nicolas" sort="Duport, Nicolas" uniqKey="Duport N" first="Nicolas" last="Duport">Nicolas Duport</name><affiliation wicri:level="1"><nlm:aff id="af4"><addr-line>Département des maladies chroniques et des traumatismes</addr-line>,<institution>Institut de veille sanitaire (InVS)</institution>,<addr-line>Saint-Maurice</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Singh Manoux, Archana" sort="Singh Manoux, Archana" uniqKey="Singh Manoux A" first="Archana" last="Singh-Manoux">Archana Singh-Manoux</name><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Epidemiology of ageing and age related diseases</addr-line>,<institution>INSERM, Centre for Research in Epidemiology and Population Health, U1018</institution>,<addr-line>Villejuif</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>University Paris-Sud, UMRS 1018</institution>,<addr-line>Villejuif</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Boussac Zarebska, Marjorie" sort="Boussac Zarebska, Marjorie" uniqKey="Boussac Zarebska M" first="Marjorie" last="Boussac-Zarebska">Marjorie Boussac-Zarebska</name><affiliation wicri:level="1"><nlm:aff id="af5"><institution>Institut de veille sanitaire (InVS), Direction scientifique et de la qualité</institution>,<addr-line>Saint-Maurice</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author><author><name sortKey="Elbaz, Alexis" sort="Elbaz, Alexis" uniqKey="Elbaz A" first="Alexis" last="Elbaz">Alexis Elbaz</name><affiliation wicri:level="1"><nlm:aff id="af1"><addr-line>Département santé travail</addr-line>,<institution>Institut de veille sanitaire (InVS)</institution>,<addr-line>Saint-Maurice</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af2"><addr-line>Department of Epidemiology of ageing and age related diseases</addr-line>,<institution>INSERM, Centre for Research in Epidemiology and Population Health, U1018</institution>,<addr-line>Villejuif</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation><affiliation wicri:level="1"><nlm:aff id="af3"><institution>University Paris-Sud, UMRS 1018</institution>,<addr-line>Villejuif</addr-line>,<country>France</country></nlm:aff><country xml:lang="fr">France</country><wicri:regionArea># see nlm:aff country strict</wicri:regionArea></affiliation></author></analytic><series><title level="j">Journal of Neurology, Neurosurgery, and Psychiatry</title><idno type="ISSN">0022-3050</idno><idno type="eISSN">1468-330X</idno><imprint><date when="2015">2015</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>Parkinson’s disease (PD) is 1.5 times more frequent in men than women. Whether age modifies this ratio is unclear. We examined whether male-to-female (M–F) ratios change with age through a French nationwide prevalence/incidence study (2010) and a meta-analysis of incidence studies.</p></sec><sec><title>Methods</title><p>We used French national drug claims databases to identify PD cases using a validated algorithm. We computed M–F prevalence/incidence ratios overall and by age using Poisson regression. Ratios were regressed on age to estimate their annual change. We identified all PD incidence studies with age/sex-specific data, and performed a meta-analysis of M–F ratios.</p></sec><sec><title>Results</title><p>On the basis of 149 672 prevalent (50% women) and 25 438 incident (49% women) cases, age-standardised rates were higher in men (prevalence=2.865/1000; incidence=0.490/1000 person-years) than women (prevalence=1.934/1000; incidence=0.328/1000 person-years). The overall M–F ratio was 1.48 for prevalence and 1.49 for incidence. Prevalence and incidence M–F ratios increased by 0.05 and 0.14, respectively, per 10 years of age. Incidence was similar in men and women under 50 years (M–F ratio <1.2, p>0.20), and over 1.6 (p<0.001) times higher in men than women above 80 years (p trend <0.001). A meta-analysis of 22 incidence studies (14 126 cases, 46% women) confirmed that M– F ratios increased with age (0.26 per 10 years, p trend=0.005).</p></sec><sec><title>Conclusions</title><p>Age-increasing M–F ratios suggest that PD aetiology changes with age. Sex-related risk/protective factors may play a different role across the continuum of age at onset. This finding may inform aetiological PD research.</p></sec></div></front><back><div1 type="bibliography"><listBibl><biblStruct><analytic><author><name sortKey="Rocca, Wa" uniqKey="Rocca W">WA Rocca</name></author><author><name sortKey="Mielke, Mm" uniqKey="Mielke M">MM Mielke</name></author><author><name sortKey="Vemuri, P" uniqKey="Vemuri P">P Vemuri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Wooten, Gf" uniqKey="Wooten G">GF Wooten</name></author><author><name sortKey="Currie, Lj" uniqKey="Currie L">LJ Currie</name></author><author><name sortKey="Bovbjerg, Ve" uniqKey="Bovbjerg V">VE Bovbjerg</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Taylor, Ks" uniqKey="Taylor K">KS Taylor</name></author><author><name sortKey="Cook, Ja" uniqKey="Cook J">JA Cook</name></author><author><name sortKey="Counsell, Ce" uniqKey="Counsell C">CE Counsell</name></author></analytic></biblStruct><biblStruct><analytic><author><name 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