DefinitionUtah residents who have been diagnosed with Parkinson's Disease
Numerator__Parkinson's Hospitalizations__: Number of hospitalizations among Utah Residents due to Parkinson's Disease (ICD9 code 332; ICD10 codes G20-G21)
__Parkinson's Mortality__: Number of deaths among Utah residents due to Parkinson's Disease (ICD10 codes G20-G21)
__Parkinson's Registry__: Number of Utah Residents with the characteristic of interest
DenominatorTotal number of persons in the population of Utah.
Data Interpretation IssuesBeginning in 2016, coding for hospitalizations changed from ICD 9 to ICD 10. The impact of this coding change is unknown at this time. Interpretations of Parkinson's Disease hospitalizations over this time change should be made with caution.
Why Is This Important?Parkinson's Disease (PD) is a progressive neurological brain disorder that affects movement. It is the second most common neurodegenerative disease after Alzheimer's disease. PD belongs to a group of conditions called motor system disorders, which are the result of a loss of dopamine-producing brain cells. The four primary symptoms of PD are tremor, rigidity/stiffness, bradykinesia (slowness of movement) and postural instability. Early symptoms of PD are subtle and occur gradually. As symptoms become more severe, carrying out activities of daily life can become difficult. PD usually affects people over the age of 60; however, younger onset of the disease can occur. Other symptoms may include depression, anxiety; difficulty swallowing, chewing, and speaking; urinary problems or constipation; skin problems; and sleep disruptions. There are currently no blood or laboratory tests used to diagnose PDl Diagnosis is based on medical history and a neurological examination. The disease can be difficult to diagnose accurately. Doctors may sometimes request brain scans or laboratory tests in order to rule out other diseases (National Institutes of Health).
The combined direct and indirect cost of Parkinson's, including treatment, social security payments and lost income, is estimated to be nearly $25 billion per year in the United States alone. Medications alone cost an average of $2,500 a year and therapeutic surgery can cost up to $100,000 per person (Parkinson's Foundation).
How Are We Doing?Approximately 5,000 Utahns have PD (Parkinson's Foundation). The Utah Parkinson's Disease registry contained 2,412 residents living with Parkinson's Disease as of December 2018. In 2017 the age-adjusted death rate in Utah was 9.8 per 100,000 people (IBIS).
How Do We Compare With the U.S.?About one million Americans live with Parkinson's disease (PD). Approximately 60,000 Americans are diagnosed with PD each year. Incidence of Parkinson's disease increases with age, but an estimated four percent of people with PD are diagnosed before age 50 (Parkinson's Foundation). The 2017 age-adjusted death rate for the United States was 8.4 per 100,000 people (Centers for Disease Control and Prevention), lower than the Utah rate.
What Is Being Done?Utah has established the Utah Parkinson's Disease Registry to improve knowledge about the causes and treatment of PD. Collecting and analyzing this information in an entire state will provide important clues about potential causes of the disease, as well as help to ensure that adequate health care resources are available for all patients.
A Parkinson's Disease Registry State Advisory Committee -- a collaboration of the Utah Department of Health, University of Utah Department of Neurology, Intermountain Neurosciences, individuals with PD, and other health care providers -- has been established to develop a state plan to guide the development of the registry. Resources for patients and their families are available through:
(1) University of Utah Department of Neurology, sponsor of the Mountain West Parkinson's Initiative (MWPI) which serves the Mountain West region, and (2) Intermountain Neurosciences Institute.
Evidence-based PracticesThere is no cure for PD but drug therapy and surgery options can alleviate PD symptoms. Regular aerobic exercise slows the progression of PD. Levodopa is the most effective treatment for PD; it is used to treat motor symptoms. This medication is taken orally and travels to the brain. When it crosses the blood-brain barrier, it is converted to dopamine. There are a variety of other medications that are used to treat motor systems related to PD based of the effectiveness for the individual (Connolly & Lang). Deep brain stimulation (DBS) is the most commonly performed surgical treatment for PD. In DBS surgery, thin wires called electrodes are placed into one or both sides of the brain in specific areas that control movement. DBS typically works best to lessen motor symptoms like stiffness, slowness and tremor (Michael J. Fox Parkinson's Foundation).
In addition to medications and surgical options, other important interventions can benefit individuals with PD. PD patients will have better outcomes if treated by a neurologist. A neurologist specializes in disorders of the central nervous system (Willis, et al.). Regular aerobic-type exercise leading to overall fitness has compelling evidence for slowing of PD progression. There are many programs available such as Rock Steady Boxing (Combs, et al.), Dance for PD (Dance for PD), and LSVT Big and Loud Therapy (Salgado, et al.). All patients with PD should be encouraged to engage in regular exercise (Ahlskog).
Health Program InformationThe Utah Chapter of the American Parkinson's Disease Association holds an annual symposium every fall. All people with the condition and caregivers are invited to attend the symposium to hear about the latest medical care from expert speakers. The Utah Chapter has also established support groups throughout the state.