Objective: To conduct a meta-analysis of the epidemiological studies of Parkinson’s disease (PD) performed in populations from least-developed to upper-middle-income countries.

Background: While several epidemiology studies and reviews focused on describing data from high-income countries, low, middle-income and emergent countries are poorly described in the literature.

Method: We conducted a systematic review and meta-analysis of the prevalence of late-onset PD (age at onset 50 years or older) in populations from least-developed to upper-middle-income countries according to OECD with reporting of 2022 and 2023. Of the included articles, only those of door-to-door design had an evaluation with a neurologist or movement disorders specialist were used in the meta-analysis. The systematic search was conducted in PubMed, Web of Science, Embase, and LILACS in February 2023. A random effects model was utilized, and Cochran’s Q and I2 tests were used to quantify heterogeneity. Metaregression using the number of participants, study quality, and GNI per capita of the country was performed.

Results: The review included 54 studies among 4,327 screened, with Asia and Pacific (40%) having the highest number of publications, followed by South/Latin America (30%) and Africa (16.67%). The mean per capita GNI was $ 3,985±3,536.

[Table1]

Ultimately, 17 studies filled our criteria for meta-analysis. The prevalence of late-onset PD was 955.7 per 100,000 habitants (95% CI: 518.44-1520.04, I2 99%, p=0). Metaregression indicated that the number of study participants was inversely associated with PD prevalence, while other factors were not correlated. When studies were divided into two groups by the median number of participants, the prevalence of PD among studies with a high number of participants was 261.4 per 100,000 habitants (95% CI: 10,47-837,29, I2 100%, p<0,01) and 1,391.87 per 100,000 habitants (95% CI: 868,01-2,033.43, I2 96%, p<0,01) in studies in the lowest group. Publication bias was positive for Egger’s test (p=0.001) but not Begg’s test (p=0.46).

[Figure1]

Conclusion: The prevalence of PD among patients 50 years or older in low to middle-income countries is similar to what is reported in previous studies. However, despite subgroup analyses and a positive publication bias test, our results are limited by high heterogeneity. Studies with low sample sizes tend to sub estimate the prevalence.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/epidemiology-of-late-onset-parkinsons-disease-in-least-developed-to-upper-middle-income-countries-a-systematic-review-and-meta-analysis/