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June 25, 2002; 58 (12) Article

Novel three-stage ascertainment method

Prevalence of PD and parkinsonism in South Tyrol, Italy

B. Kis, A. Schrag, Y. Ben-Shlomo, C. Klein, A. Gasperi, F. Spoegler, R. Schoenhuber, P. P. Pramstaller
First published June 25, 2002, DOI: https://doi.org/10.1212/WNL.58.12.1820
B. Kis
From the Department of Neurology (Drs. Kis, Schoenhuber, and Pramstaller), Regional General Hospital Bozen/Bolzano, Department of Neurology (Dr. Gasperi), General Hospital Bruneck/Brunico, and Department of Neurology (Dr. Spoegler), General Hospital Brixen/Bressanone, Italy; Department of Neurology (Dr. Kis), Alfried Krupp Hospital, Essen, and Department of Neurology (Dr. Klein), Medical University of Luebeck, Germany; and Department of Clinical Neurology (Dr. Schrag), Institute of Neurology, London, and Department of Social Medicine (Dr. Ben-Shlomo), University of Bristol, UK.
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A. Schrag
From the Department of Neurology (Drs. Kis, Schoenhuber, and Pramstaller), Regional General Hospital Bozen/Bolzano, Department of Neurology (Dr. Gasperi), General Hospital Bruneck/Brunico, and Department of Neurology (Dr. Spoegler), General Hospital Brixen/Bressanone, Italy; Department of Neurology (Dr. Kis), Alfried Krupp Hospital, Essen, and Department of Neurology (Dr. Klein), Medical University of Luebeck, Germany; and Department of Clinical Neurology (Dr. Schrag), Institute of Neurology, London, and Department of Social Medicine (Dr. Ben-Shlomo), University of Bristol, UK.
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Y. Ben-Shlomo
From the Department of Neurology (Drs. Kis, Schoenhuber, and Pramstaller), Regional General Hospital Bozen/Bolzano, Department of Neurology (Dr. Gasperi), General Hospital Bruneck/Brunico, and Department of Neurology (Dr. Spoegler), General Hospital Brixen/Bressanone, Italy; Department of Neurology (Dr. Kis), Alfried Krupp Hospital, Essen, and Department of Neurology (Dr. Klein), Medical University of Luebeck, Germany; and Department of Clinical Neurology (Dr. Schrag), Institute of Neurology, London, and Department of Social Medicine (Dr. Ben-Shlomo), University of Bristol, UK.
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C. Klein
From the Department of Neurology (Drs. Kis, Schoenhuber, and Pramstaller), Regional General Hospital Bozen/Bolzano, Department of Neurology (Dr. Gasperi), General Hospital Bruneck/Brunico, and Department of Neurology (Dr. Spoegler), General Hospital Brixen/Bressanone, Italy; Department of Neurology (Dr. Kis), Alfried Krupp Hospital, Essen, and Department of Neurology (Dr. Klein), Medical University of Luebeck, Germany; and Department of Clinical Neurology (Dr. Schrag), Institute of Neurology, London, and Department of Social Medicine (Dr. Ben-Shlomo), University of Bristol, UK.
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A. Gasperi
From the Department of Neurology (Drs. Kis, Schoenhuber, and Pramstaller), Regional General Hospital Bozen/Bolzano, Department of Neurology (Dr. Gasperi), General Hospital Bruneck/Brunico, and Department of Neurology (Dr. Spoegler), General Hospital Brixen/Bressanone, Italy; Department of Neurology (Dr. Kis), Alfried Krupp Hospital, Essen, and Department of Neurology (Dr. Klein), Medical University of Luebeck, Germany; and Department of Clinical Neurology (Dr. Schrag), Institute of Neurology, London, and Department of Social Medicine (Dr. Ben-Shlomo), University of Bristol, UK.
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F. Spoegler
From the Department of Neurology (Drs. Kis, Schoenhuber, and Pramstaller), Regional General Hospital Bozen/Bolzano, Department of Neurology (Dr. Gasperi), General Hospital Bruneck/Brunico, and Department of Neurology (Dr. Spoegler), General Hospital Brixen/Bressanone, Italy; Department of Neurology (Dr. Kis), Alfried Krupp Hospital, Essen, and Department of Neurology (Dr. Klein), Medical University of Luebeck, Germany; and Department of Clinical Neurology (Dr. Schrag), Institute of Neurology, London, and Department of Social Medicine (Dr. Ben-Shlomo), University of Bristol, UK.
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R. Schoenhuber
From the Department of Neurology (Drs. Kis, Schoenhuber, and Pramstaller), Regional General Hospital Bozen/Bolzano, Department of Neurology (Dr. Gasperi), General Hospital Bruneck/Brunico, and Department of Neurology (Dr. Spoegler), General Hospital Brixen/Bressanone, Italy; Department of Neurology (Dr. Kis), Alfried Krupp Hospital, Essen, and Department of Neurology (Dr. Klein), Medical University of Luebeck, Germany; and Department of Clinical Neurology (Dr. Schrag), Institute of Neurology, London, and Department of Social Medicine (Dr. Ben-Shlomo), University of Bristol, UK.
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P. P. Pramstaller
From the Department of Neurology (Drs. Kis, Schoenhuber, and Pramstaller), Regional General Hospital Bozen/Bolzano, Department of Neurology (Dr. Gasperi), General Hospital Bruneck/Brunico, and Department of Neurology (Dr. Spoegler), General Hospital Brixen/Bressanone, Italy; Department of Neurology (Dr. Kis), Alfried Krupp Hospital, Essen, and Department of Neurology (Dr. Klein), Medical University of Luebeck, Germany; and Department of Clinical Neurology (Dr. Schrag), Institute of Neurology, London, and Department of Social Medicine (Dr. Ben-Shlomo), University of Bristol, UK.
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Citation
Novel three-stage ascertainment method
Prevalence of PD and parkinsonism in South Tyrol, Italy
B. Kis, A. Schrag, Y. Ben-Shlomo, C. Klein, A. Gasperi, F. Spoegler, R. Schoenhuber, P. P. Pramstaller
Neurology Jun 2002, 58 (12) 1820-1825; DOI: 10.1212/WNL.58.12.1820

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Abstract

Background: A number of community-based studies on the prevalence of PD have been conducted worldwide, but they are often extremely costly and time consuming.

Objective: To assess the prevalence of PD and parkinsonism for the population aged between 60 and 85 years in South Tyrol, Northern Italy, using a novel population-based three-stage ascertainment method.

Methods: Seven hundred fifty persons aged 60 to 85 years from South Tyrol received a validated screening mail questionnaire for parkinsonism. In the second stage of the ascertainment method, trained primary care physicians (PCP) identified all persons with possible parkinsonism among those screened positive. In the third stage, movement disorders specialists excluded or confirmed the diagnosis in all identified people.

Results: The response rate was 87.6%. The prevalence rate per 100 population over 65 years of age was 1.5 (95% CI 0.6 to 2.3) for PD and 2.2 (95% CI 1.2 to 3.3) for parkinsonism after having been adjusted to the 1991 European standard population. Overall, 78% (95% CI 59 to 96%) of patients with parkinsonism were newly detected through the survey.

Conclusions: The prevalence of PD and parkinsonism in people aged over 65 in South Tyrol was similar to that observed in door-to-door surveys in other European countries. The novel three-stage case ascertainment method employed proved a useful tool to substitute for expensive door-to-door surveys for prevalence studies of parkinsonism, detecting a high number of undiagnosed cases, particularly in geographically remote areas.

  • Received August 2, 2001.
  • Accepted in final form March 12, 2002.
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