De ziekte van Parkinson in Nederland. Ontwikkelingen inde kennis van de epidemiologie, etiologie en mogelijkheden voor preventie
1994
Since chronic diseases are becoming more prevalent in our society, there
is a growing need for state-of-the-art reviews of developments in the
knowledge of etiology, determinants and prevention of chronic diseases.
This report is about Parkinson's disease. It is focused on the
epidemiology of Parkinson's disease in the Netherlands, the etiology and
determinants of the disease and possibilities of primary, secondary or
tertiary prevention, especially in relation to life-style. In the
Netherlands it is estimated that there are about 13.500 to 35.000
persons with Parkinson's disease and that every year 1.700 new cases of
Parkinson's disease are diagnosed. These estimates are based on
registration in general practice. In a population sample of elderly
persons (55+) there appeared to be 11 per 1.000 men (95%-confidence
interval 7-16) and 15 per 1.000 women (95%-confidence interval 11-19),
which means 15.300 men and 26.300 women with Parkinson's disease. It
makes Parkinson's disease one of the more common diseases in the elderly.
A variety of factors contribute to the development of Parkinson's
disease. These factors include combinations of genetic predisposition,
aging and environment, and could vary between persons. To date the
results of genetic research are inconclusive. So, many investigators
postulate an important role for environmental factors in the development
of Parkinson's disease. Proposals for specific putative environmental
factors include viruses, metals and toxins. Smoking has often been
reported to be less common in Parkinson's disease, and this has also been
proposed to relate to its etiology. However, the cause of Parkinson's
disease is unknown. Also there is not much knowledge of life-style as a
cause of Parkinson's disease. Physical exercise and food constituents
such as vitamin E might have a protective effect, but more research is
still needed.Primary and secondary preventive measures aimed at
life-style factors are hard to formulate. Tertiary prevention might be
possible because physical exercise or speech therapy could prevent
complications such as falling and swallowing the wrong way. The several
possibilities still have to be examined on effectiveness and efficiency.
More research on this topic is recommended.
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