Prodromal, established, and advanced Parkinson’s disease and atypical parkinsonisms: Prevalence and healthcare service utilization in the Catalan Health Surveillance System (Catpark study)

Introduction

There are several studies on epidemiology, healthcare services utilization, and associated expenditures among patients with Parkinson's disease (PD), but evidence is scanty regarding prodromal PD and atypical parkinsonisms (APs). We seek to describe all these aspects in Catalonia.

Methods

Retrospective cross-sectional study of patients with prodromal, established, and advanced PD and APs from the Catalan Health Surveillance System during 2021 based on PD, APs and related diagnostic codes and compared to the population without PD and APs adjusted for age, sex, and income level.

Results

We analyzed data from 55,751 patients with a mean age of 68.7 (SD ± 18.2) years. Established and prodromal PD were the most prevalent (2991.4 and 2539.2 cases/million, respectively), with prodromal PD exhibiting the highest incidence rate (444.2 cases/million). Conversely, APs had the lowest prevalence and incidence rates (209.4 and 46.4 cases/million). The mortality rate was 6.48 per 100 inhabitants and was higher in patients with advanced PD and in those with APs, increasing both with age and Adjusted Morbidity Groups (Grups de Morbilitat Ajustats, GMA) comorbidity risk. Mortality was higher in the PD population compared to the control population. Healthcare service utilization and institutionalization rates were significantly higher in the PD + APs population, particularly among patients with advanced PD and APs.

Conclusion

This study provides novel insights into the characteristics, epidemiology, healthcare service utilization, and associated costs of patients with PD, including potential prodromal stage cases, and APs in Catalonia, underscoring the significant burden of PD and APs and their substantial demand on healthcare resources.