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      Epidemiology of Parkinson's Disease—East Versus West

      review-article
      , MD, DM 1 , 2 , , BA, MB BChir, MA, FRACP 1 , 2 , , MBBS, FRCP 1 , 2 , 3 ,
      Movement Disorders Clinical Practice
      John Wiley and Sons Inc.
      epidemiology, Parkinson's disease, risk factors

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          Abstract

          Background

          The cause of PD at present remains unknown. A number of epidemiological studies have been conducted across the globe to ascertain the disease burden and the possible risk factors. In this review, we analyze the various studies from East and West with an aim to observe the important similarities and differences in the disease occurrence and risk factor profile.

          Methods

          A comprehensive search of descriptive and analytical epidemiological studies was undertaken. The descriptive studies and meta‐analysis providing the standardised population rates were selected. The demographics, ethnicity and geographical differences between East and West were analysed. In analytical epidemiology, more established and well‐studied non‐genetic risk factors for PD were reviewed utilising the prospective cohort studies, case control studies and meta‐analysis where available.

          Results and Conclusion

          PD is more common with increasing age and shows male predominance, which is more obvious in Western studies. The PD prevalence and incidence rates are slightly lower in the East compared to the West. Incidence studies on different ethnic populations in the same country have also found a lower occurrence of PD amongst Easterners compared to Westerners. Setting methodological differences aside, studies from East and West suggest a role for both environmental and genetic risk factors in PD causation. Smoking, caffeine intake and pesticide exposure are well‐established risk factors across regions. There is a robust data for dairy product consumption, urate levels and physical activity in the West while studies on certain risk factors like head injury and alcohol show conflicting and mixed results.

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          Most cited references77

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          Purine-rich foods, dairy and protein intake, and the risk of gout in men.

          Various purine-rich foods and high protein intake have long been thought to be risk factors for gout. Similarly, the possibility that the consumption of dairy products has a role in protecting against gout has been raised by metabolic studies. We prospectively investigated the association of these dietary factors with new cases of gout. Over a 12-year period, we prospectively examined the relationship between purported dietary risk factors and new cases of gout among 47,150 men who had no history of gout at base line. We used a supplementary questionnaire to ascertain whether participants met the American College of Rheumatology survey criteria for gout. Diet was assessed every four years by means of a food-frequency questionnaire. During the 12 years of the study, we documented 730 confirmed new cases of gout. The multivariate relative risk of gout among men in the highest quintile of meat intake, as compared with those in the lowest quintile, was 1.41 (95 percent confidence interval, 1.07 to 1.86; P for trend = 0.02), and the corresponding relative risk associated with seafood intake was 1.51 (95 percent confidence interval, 1.17 to 1.95; P for trend = 0.02). In contrast, the incidence of gout decreased with increasing intake of dairy products; the multivariate relative risk among men in the highest quintile, as compared with those in the lowest quintile, was 0.56 (95 percent confidence interval, 0.42 to 0.74; P for trend <0.001). The level of consumption of purine-rich vegetables and the total protein intake were not associated with an increased risk of gout. Higher levels of meat and seafood consumption are associated with an increased risk of gout, whereas a higher level of consumption of dairy products is associated with a decreased risk. Moderate intake of purine-rich vegetables or protein is not associated with an increased risk of gout. Copyright 2004 Massachusetts Medical Society
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            Uric acid provides an antioxidant defense in humans against oxidant- and radical-caused aging and cancer: a hypothesis.

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              Epidemiology of mild traumatic brain injury and neurodegenerative disease.

              Every year an estimated 42 million people worldwide suffer a mild traumatic brain injury (MTBI) or concussion. More severe traumatic brain injury (TBI) is a well-established risk factor for a variety of neurodegenerative diseases including Alzheimer's disease, Parkinson's disease, and amyotrophic lateral sclerosis (ALS). Recently, large epidemiological studies have additionally identified MTBI as a risk factor for dementia. The role of MTBI in risk of PD or ALS is less well established. Repetitive MTBI and repetitive sub-concussive head trauma have been linked to increased risk for a variety of neurodegenerative diseases including chronic traumatic encephalopathy (CTE). CTE is a unique neurodegenerative tauopathy first described in boxers but more recently described in a variety of contact sport athletes, military veterans, and civilians exposed to repetitive MTBI. Studies of repetitive MTBI and CTE have been limited by referral bias, lack of consensus clinical criteria for CTE, challenges of quantifying MTBI exposure, and potential for confounding. The prevalence of CTE is unknown and the amount of MTBI or sub-concussive trauma exposure necessary to produce CTE is unclear. This review will summarize the current literature regarding the epidemiology of MTBI, post-TBI dementia and Parkinson's disease, and CTE while highlighting methodological challenges and critical future directions of research in this field. This article is part of a Special Issue entitled SI:Traumatic Brain Injury.
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                Author and article information

                Contributors
                louis_tan@nni.com.sg
                Journal
                Mov Disord Clin Pract
                Mov Disord Clin Pract
                10.1002/(ISSN)2330-1619
                MDC3
                Movement Disorders Clinical Practice
                John Wiley and Sons Inc. (Hoboken )
                2330-1619
                22 December 2017
                Jan-Feb 2018
                : 5
                : 1 ( doiID: 10.1002/mdc3.2018.5.issue-1 )
                : 14-28
                Affiliations
                [ 1 ] Department of Neurology National Neuroscience Institute Singapore
                [ 2 ] Parkinson's Disease and Movement Disorders Centre National Neuroscience Institute NPF International Center of Excellence Singapore
                [ 3 ] Duke‐NUS Graduate Medical School Singapore
                Author notes
                [*] [* ] Correspondence to: Louis C.S. Tan, Department of Neurology, National Neuroscience Institute, Singapore, 11 Jalan Tan Tock Seng, Singapore 308433; E‐mail: louis_tan@ 123456nni.com.sg
                Article
                PMC6174379 PMC6174379 6174379 MDC312568
                10.1002/mdc3.12568
                6174379
                30363342
                7fc05f06-798d-4888-a91e-b7e9ba0c7cd3
                © 2017 International Parkinson and Movement Disorder Society
                History
                : 30 July 2017
                : 20 October 2017
                : 02 November 2017
                Page count
                Figures: 2, Tables: 3, Pages: 15, Words: 11787
                Funding
                Funded by: Singapore National Research Foundation
                Funded by: Translational and Clinical Research Flagship Programme
                Award ID: TCR12dec010
                Funded by: Singapore Ministry of Health's National Medical Research Council
                Categories
                Review
                Reviews
                Custom metadata
                2.0
                mdc312568
                January/February 2018
                Converter:WILEY_ML3GV2_TO_NLMPMC version:version=5.5.0 mode:remove_FC converted:08.10.2018

                risk factors,epidemiology,Parkinson's disease
                risk factors, epidemiology, Parkinson's disease

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