Different prevalence rates of Parkinson's disease in urban and rural areas: a population-based study in Taiwan.
BACKGROUND
Rural living has long been debated as a risk factor for idiopathic Parkinson's disease (IPD). But few community-based studies compared this difference between urban and rural areas.


METHODS
Population-based surveys by neurologists using a standardized diagnostic protocol were conducted in the urban areas of Keelung City and compared the prevalence rates of IPD with those we had previously determined in the rural area of Ilan County, Taiwan. Subjects were diagnosed with IPD when at least 2 of the 4 cardinal signs of parkinsonism were present and by exclusion of secondary parkinsonism. Gender-specific age-standardized prevalence rates of IPD by using the 1970 and 2000 US censuses were calculated for comparison.


RESULTS
The participation rate was 84.9%. The crude prevalence rate of IPD in persons aged 40 years and over was 706 (95% CI: 551-864) per 100,000 population. The age-adjusted prevalence rates by using the 1970 US census were 633 (95% CI: 620-646) for people aged 40 and over and 230 (95% CI: 227-234) for all ages. Our results were similar to those obtained in Sicily, Rotterdam, and 3 communities in China. Moreover, the prevalence rates of IPD in Keelung, the urban area studied, were twice as high as those in Ilan, the rural area studied (p < 0.001).


CONCLUSIONS
Our results suggest that urban living is more important as a risk factor for IPD development than rural living in Taiwan.
Chen
Chih Chuan
CC
Department of Neurology, College of Public Health, National Taiwan University, Taipei 100, Taiwan.
Chen
Ta Fu
TF
Hwang
Yuarn Chung
YC
Wen
Ying Rong
YR
Chiu
Yueh Hsia
YH
Wu
Chia Yun
CY
Chen
Rong Chi
RC
Tai
John Jen
JJ
Chen
Tony Hsiu Hsi
TH
Liou
Horng Huei
HH
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology*; D011159:Population Surveillance; D015995:Prevalence; D012424:Rural Population / Q000706:statistics & numerical data*; D012680:Sensitivity and Specificity; D017678:Sex Distribution; D013624:Taiwan / Q000453:epidemiology; D014505:Urban Population / Q000706:statistics & numerical data*