Objective: We examined the UK incidence, prevalence and survival for eight parkinsonian disorders including Parkinson’s disease (PD) from 2003 to 2023, using primary and secondary care data.

Background: Increases in Parkinson’s disease (PD) prevalence are less pronounced in higher income countries, and incidence studies give contradictory findings. Comparative data for other types of parkinsonism, and for survival, are rare.

Method: We calculated the standardised incidence and prevalence rates of PD and other parkinsonian disorders in a population-based UK study. We modelled temporal trends over 21 years with Poisson regression and examined how they varied by demographic factors. Survival was calculated using Kaplan-Meier methods. Future projections of cases were estimated using national population statistics.

Results: The total sample population was around 18 million in 2023 with almost 358 million person-years over the 21 years. The standardised incidence of PD was 23.3 (95% confidence interval (CI) 22.6, 24.0) and the standardised prevalence of PD was 240 (CI 238, 242) per 100,000 in 2023. Incidence and prevalence rates for PD before COVID-19 showed slight reductions but there were substantial increases in rates for other degenerative parkinsonian disorders. Post COVID-19 rates were lower for all disorders, e.g. PD incidence fell by 22.6% (CI 20.1, 24.7).

PD incidence and prevalence declined with increasing deprivation. Incidence was 43% lower (CI 16, 62) in people of African/Caribbean ethnicity, but similar for Asian and White ethnicity. Of the degenerative parkinsonisms, 5-year survival was worst for Progressive Supranuclear Palsy at 30.5% (29.3, 31.8) and best for PD at 64.2% (64.0, 64.4). Younger onset cases had the greatest absolute reductions in life expectancy. Total numbers of people with PD increased over time, and then declined in the COVID-19 period, but are predicted to exceed pre-COVID levels by 2026.

Conclusion: Increasing diagnosis of atypical parkinsonisms has contributed to changing temporal trends for PD. Ethnic variations justify more genetic and environmental studies in people of non-European ethnicity. Increased mortality from degenerative parkinsonism, particularly young-onset, serves as a baseline for assessing disease-modifying therapies. Greater social care and health service provision will be required for progressively greater numbers of people with PD and parkinsonism.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/secular-trends-and-survival-of-parkinsons-disease-and-other-forms-of-parkinsonism-in-the-united-kingdom/