Incidence and time trends of drug-induced parkinsonism

A 30-year population-based study

Rodolfo Savica, Brandon R. Grossardt, James H. Bower, J. Eric Ahlskog, Michelle M. Mielke, Walter A. Rocca

Research output: Contribution to journalArticle

Abstract

Background: Epidemiological studies of drug-induced parkinsonism remain limited. Objectives: To investigate the incidence and time trends of drug-induced parkinsonism over 30 years in a geographically defined American population. Methods: We used the medical records-linkage system of the Rochester Epidemiology Project to identify all persons in Olmsted County, Minnesota, who received a screening diagnostic code for parkinsonism from 1976 through 2005. A movement disorders specialist reviewed the complete medical records of each person to confirm the presence of drug-induced parkinsonism associated with dopamine-blocking or dopamine-depleting medications. Results: Among 906 incident cases of parkinsonism from 1976 to 2005, 108 persons had drug-induced parkinsonism (11.9%). The average annual incidence rate of drug-induced parkinsonism was 3.3 per 100,000 person-years, was higher in women, and increased with older age. Drug-induced parkinsonism was the fifth-most common type of parkinsonism overall; however, it was the most common type among persons younger than age 40 years. Typical antipsychotic drugs were the most common class of drugs associated with parkinsonism, whereas atypical antipsychotic drugs were rarely involved. The incidence rate of drug-induced parkinsonism decreased 32.0% per decade (relative risk=0.68; 95% confidence interval: 0.49-0.94) and 68.6% over the 30 years of the study. The decrease was similar in men (65.2%) and women (69.4%); however, the trend was significant only in women. Conclusions: The incidence of drug-induced parkinsonism increased with older age and was higher in women at all ages. Typical antipsychotic drugs were the most common cause. The incidence of drug-induced parkinsonism decreased over the 30 years of the study because of changes in drug use.

Original languageEnglish (US)
JournalMovement Disorders
DOIs
StateAccepted/In press - 2016
Externally publishedYes

Fingerprint

Parkinsonian Disorders
Incidence
Pharmaceutical Preparations
Population
Antipsychotic Agents
Medical Record Linkage
Dopamine
Movement Disorders
Medical Records
Epidemiologic Studies
Epidemiology

Keywords

  • Drug-induced parkinsonism
  • Incidence
  • Parkinsonism
  • Sex differences
  • Time trends

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

Cite this

Savica, R., Grossardt, B. R., Bower, J. H., Ahlskog, J. E., Mielke, M. M., & Rocca, W. A. (Accepted/In press). Incidence and time trends of drug-induced parkinsonism: A 30-year population-based study. Movement Disorders. https://doi.org/10.1002/mds.26839

Incidence and time trends of drug-induced parkinsonism : A 30-year population-based study. / Savica, Rodolfo; Grossardt, Brandon R.; Bower, James H.; Ahlskog, J. Eric; Mielke, Michelle M.; Rocca, Walter A.

In: Movement Disorders, 2016.

Research output: Contribution to journalArticle

Savica, Rodolfo ; Grossardt, Brandon R. ; Bower, James H. ; Ahlskog, J. Eric ; Mielke, Michelle M. ; Rocca, Walter A. / Incidence and time trends of drug-induced parkinsonism : A 30-year population-based study. In: Movement Disorders. 2016.
@article{3646251a450649d995d202415775b286,
title = "Incidence and time trends of drug-induced parkinsonism: A 30-year population-based study",
abstract = "Background: Epidemiological studies of drug-induced parkinsonism remain limited. Objectives: To investigate the incidence and time trends of drug-induced parkinsonism over 30 years in a geographically defined American population. Methods: We used the medical records-linkage system of the Rochester Epidemiology Project to identify all persons in Olmsted County, Minnesota, who received a screening diagnostic code for parkinsonism from 1976 through 2005. A movement disorders specialist reviewed the complete medical records of each person to confirm the presence of drug-induced parkinsonism associated with dopamine-blocking or dopamine-depleting medications. Results: Among 906 incident cases of parkinsonism from 1976 to 2005, 108 persons had drug-induced parkinsonism (11.9{\%}). The average annual incidence rate of drug-induced parkinsonism was 3.3 per 100,000 person-years, was higher in women, and increased with older age. Drug-induced parkinsonism was the fifth-most common type of parkinsonism overall; however, it was the most common type among persons younger than age 40 years. Typical antipsychotic drugs were the most common class of drugs associated with parkinsonism, whereas atypical antipsychotic drugs were rarely involved. The incidence rate of drug-induced parkinsonism decreased 32.0{\%} per decade (relative risk=0.68; 95{\%} confidence interval: 0.49-0.94) and 68.6{\%} over the 30 years of the study. The decrease was similar in men (65.2{\%}) and women (69.4{\%}); however, the trend was significant only in women. Conclusions: The incidence of drug-induced parkinsonism increased with older age and was higher in women at all ages. Typical antipsychotic drugs were the most common cause. The incidence of drug-induced parkinsonism decreased over the 30 years of the study because of changes in drug use.",
keywords = "Drug-induced parkinsonism, Incidence, Parkinsonism, Sex differences, Time trends",
author = "Rodolfo Savica and Grossardt, {Brandon R.} and Bower, {James H.} and Ahlskog, {J. Eric} and Mielke, {Michelle M.} and Rocca, {Walter A.}",
year = "2016",
doi = "10.1002/mds.26839",
language = "English (US)",
journal = "Movement Disorders",
issn = "0885-3185",
publisher = "John Wiley and Sons Inc.",

}

TY - JOUR

T1 - Incidence and time trends of drug-induced parkinsonism

T2 - A 30-year population-based study

AU - Savica, Rodolfo

AU - Grossardt, Brandon R.

AU - Bower, James H.

AU - Ahlskog, J. Eric

AU - Mielke, Michelle M.

AU - Rocca, Walter A.

PY - 2016

Y1 - 2016

N2 - Background: Epidemiological studies of drug-induced parkinsonism remain limited. Objectives: To investigate the incidence and time trends of drug-induced parkinsonism over 30 years in a geographically defined American population. Methods: We used the medical records-linkage system of the Rochester Epidemiology Project to identify all persons in Olmsted County, Minnesota, who received a screening diagnostic code for parkinsonism from 1976 through 2005. A movement disorders specialist reviewed the complete medical records of each person to confirm the presence of drug-induced parkinsonism associated with dopamine-blocking or dopamine-depleting medications. Results: Among 906 incident cases of parkinsonism from 1976 to 2005, 108 persons had drug-induced parkinsonism (11.9%). The average annual incidence rate of drug-induced parkinsonism was 3.3 per 100,000 person-years, was higher in women, and increased with older age. Drug-induced parkinsonism was the fifth-most common type of parkinsonism overall; however, it was the most common type among persons younger than age 40 years. Typical antipsychotic drugs were the most common class of drugs associated with parkinsonism, whereas atypical antipsychotic drugs were rarely involved. The incidence rate of drug-induced parkinsonism decreased 32.0% per decade (relative risk=0.68; 95% confidence interval: 0.49-0.94) and 68.6% over the 30 years of the study. The decrease was similar in men (65.2%) and women (69.4%); however, the trend was significant only in women. Conclusions: The incidence of drug-induced parkinsonism increased with older age and was higher in women at all ages. Typical antipsychotic drugs were the most common cause. The incidence of drug-induced parkinsonism decreased over the 30 years of the study because of changes in drug use.

AB - Background: Epidemiological studies of drug-induced parkinsonism remain limited. Objectives: To investigate the incidence and time trends of drug-induced parkinsonism over 30 years in a geographically defined American population. Methods: We used the medical records-linkage system of the Rochester Epidemiology Project to identify all persons in Olmsted County, Minnesota, who received a screening diagnostic code for parkinsonism from 1976 through 2005. A movement disorders specialist reviewed the complete medical records of each person to confirm the presence of drug-induced parkinsonism associated with dopamine-blocking or dopamine-depleting medications. Results: Among 906 incident cases of parkinsonism from 1976 to 2005, 108 persons had drug-induced parkinsonism (11.9%). The average annual incidence rate of drug-induced parkinsonism was 3.3 per 100,000 person-years, was higher in women, and increased with older age. Drug-induced parkinsonism was the fifth-most common type of parkinsonism overall; however, it was the most common type among persons younger than age 40 years. Typical antipsychotic drugs were the most common class of drugs associated with parkinsonism, whereas atypical antipsychotic drugs were rarely involved. The incidence rate of drug-induced parkinsonism decreased 32.0% per decade (relative risk=0.68; 95% confidence interval: 0.49-0.94) and 68.6% over the 30 years of the study. The decrease was similar in men (65.2%) and women (69.4%); however, the trend was significant only in women. Conclusions: The incidence of drug-induced parkinsonism increased with older age and was higher in women at all ages. Typical antipsychotic drugs were the most common cause. The incidence of drug-induced parkinsonism decreased over the 30 years of the study because of changes in drug use.

KW - Drug-induced parkinsonism

KW - Incidence

KW - Parkinsonism

KW - Sex differences

KW - Time trends

UR - http://www.scopus.com/inward/record.url?scp=84998813239&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84998813239&partnerID=8YFLogxK

U2 - 10.1002/mds.26839

DO - 10.1002/mds.26839

M3 - Article

JO - Movement Disorders

JF - Movement Disorders

SN - 0885-3185

ER -