Prevalence of neurodegenerative parkinsonism in an isolated population in south-eastern Moravia, Czech Republic

Excerpt

Parkinson’s disease (PD) and parkinsonism are the most prevalent chronic neurological disorders in the elderly. The prevalence of PD in Europe in the population over 65 years of age is reported as approximately 1.6 %, with a little variation among European countries ranging from 1.1 to 2.2 % [1‐6]. It has been suggested that the prevalence of neurodegenerative diseases in a small, isolated European communities might be higher than in the general population [5, 7]. We have observed possible rebound of such a phenomenon, i.e., more frequent referrals of patients with parkinsonism to neurological outpatient clinics, in a small village in south-eastern Moravia (Lipov, 69634 Czech Republic, 1,524 inhabitants according to the 2011 census), where a low regional mobility and a traditional lifestyle are preserved. Subsequently, this population was investigated using a three-stage case ascertainment method that was successfully introduced in a previous neuroepidemiological study in South Tyrol [7]. In the first stage, screening questionnaires with a cover letter were delivered to all of the occupied houses in the village. Residents were instructed to deliver the completed questionnaire to the local general practitioner’s office. In the second stage, those who screened positively for parkinsonism according to the questionnaire were examined by a trained primary care neurologist, and a preliminary diagnosis of parkinsonism was made or eliminated. In the third stage, all respondents in whom parkinsonism was presumed were admitted to the corresponding author’s hospital for a detailed examination in the tertiary movement disorders center. In this stage, parkinsonism was diagnosed when the subject met UK-PDBB criteria for the diagnosis of PD [8], i.e. the presence of two of four symptoms (bradykinesia and resting tremor or rigidity or impaired postural stability). Prevalence was calculated by age group as the number of cases relative to the number of village inhabitants. …