Global Burden of Early-Onset Parkinson Disease Has Increased Significantly Since 1990

The incidence, prevalence, and disability burden of early-onset Parkinson disease (PD) have risen substantially over the past three decades, according to results from the Global Burden of Disease 2021 study published in Journal of Neurology, Neurosurgery & Psychiatry.

Early-onset PD, occurring between ages 20 and 50 years, was once considered rare, but emerging data suggest an accelerating burden on younger adults worldwide. Researchers assessed global trends in early-onset PD between 1990 and 2021, focusing on incident cases, prevalence, years lived with disability (YLDs), and disability-adjusted life years (DALYs).

A population-based, retrospective analysis using the Global Burden of Disease 2021 database included individuals with early onset PD, examining trends by age, gender, and socioeconomic regions. Age-standardized rates were calculated per 100,000 population, and temporal changes were reported as average annual percent change. The researchers also assessed the proportion of early-onset PD burden attributable to smoking.

EOPD is an increasingly serious global health issue that requires significant attention from both the WHO and individual nations.

In 2021, there were an estimated 81,047 new cases of early onset PD, 483,872 prevalent cases, and 78,423 YLDs, representing 6.07%, 4.11%, and 4.70% of the overall PD burden, respectively. The global age-standardized incidence, prevalence, and YLD rates were 2.35 (95% CI, 1.39-3.55), 14.00 (95% CI, 9.49-19.79), and 2.27 (95% CI, 1.34-3.50) per 100,000 individuals, respectively. Men consistently exhibited higher incidence and disability rates compared with women, with DALYs rising exponentially with increasing age within the 20 to 49-year range.

Geographic variation was observed, with Peru, Bolivia, Ecuador, and China reporting the highest incidence and prevalence rates in 2021, while Saudi Arabia, Afghanistan, and North Korea had the highest DALY burden. Across socioeconomic categories, middle and high-middle Socio-Demographic Index countries carried the heaviest burden.

From 1990 to 2021, global early-onset PD incidence increased by 286.72%, prevalence by 239.34%, and YLDs by 249.59%. Age-standardized rates also increased, with East Asia, particularly China, experiencing the most rapid growth. Norway similarly demonstrated marked increases, likely reflecting the expansion of comprehensive national PD registries.

While smoking, a known risk factor inversely associated with PD, remained the only quantifiable risk factor for early-onset PD in the Global Burden of Disease analysis, its protective effect weakened over time. In 1990, smoking reduced DALY burden by 14.14%; by 2021, this had declined to 9.03%. The effect was more pronounced in men compared with women, with regional differences most evident in Eastern Europe and East Asia.

Study limitations include potential bias in country-level data due to varying registry quality, possible underestimation of disease burden in low-income regions, restriction of risk factor analysis to smoking alone, and incomplete disability data for the youngest age group (20 to 29 years).

“[Early-onset] PD is an increasingly serious global health issue that requires significant attention from both the WHO and individual nations,” the study authors concluded.

Disclosures: This research was supported by the Huadong Medicine Joint Funds of the Zhejiang Provincial Natural Science Foundation of China, the National Natural Science Foundation of China, the Fujian Provincial Natural Science Foundation, the Fujian Provincial Health Technology Project, and the Medical Discipline Construction Project of the Pudong Health Committee of Shanghai.