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@ARTICLE{Fink:277791,
      author       = {Fink, Anne and Pavlou, Maria Angeliki S and Roomp, Kirsten
                      and Schneider, Jochen G},
      title        = {{D}eclining trends in the incidence of {P}arkinson's
                      disease: {A} cohort study in {G}ermany.},
      journal      = {Journal of Parkinson's Disease},
      volume       = {15},
      number       = {1},
      issn         = {1877-7171},
      address      = {Amsterdam},
      publisher    = {IOS Press},
      reportid     = {DZNE-2025-00469},
      pages        = {1877718X241306132},
      year         = {2025},
      abstract     = {BackgroundEpidemiologic evidence from different countries
                      shows both increasing and decreasing incidence rates of
                      Parkinson's disease over time without clear
                      trends.ObjectiveWe aimed to investigate age-specific
                      incidence rates of Parkinson's disease and possible
                      explanations for the observed trends in Germany over a
                      10-year period.MethodsTwo different random samples of
                      subjects aged ≥50 years included in 2004-2009 and
                      2014-2019, each consisting of 250,000 individuals, were
                      drawn from Germany's largest health care insurance company
                      followed up for new Parkinson's disease cases. We compared
                      the age-specific incidence rates of Parkinson's disease for
                      both cohorts and performed Cox regression models to
                      calculate the hazard ratios (HR) of PD in the second period
                      compared with the first period, adjusted for age, sex, and
                      risk factors for Parkinson's disease.ResultsFor most age
                      groups in men and in women, we found lower age-specific
                      Parkinson's disease incidence rates in the second period.
                      Cox regression analysis showed an overall $18\%$ risk
                      reduction in Parkinson's disease incidence (HR = 0.82,
                      $95\%$ confidence interval [0.76-0.89]). Mean age at
                      diagnosis increased in men (+1.9 years) and women (+0.8
                      years). After adjustment for risk factors, the HR was 0.78
                      [0.72-0.85]. Sensitivity analysis considering the competing
                      event of death showed an HR of 0.79 [0.73-0.86]),
                      demonstrating the independence of time trends from changes
                      in death rates.ConclusionsOur data show that the risk of
                      Parkinson's disease has decreased over time and that this
                      decrease is independent of factors such as changes in death
                      rates, age structure, sex, and specific risk factors.},
      keywords     = {Humans / Parkinson Disease: epidemiology / Germany:
                      epidemiology / Male / Female / Incidence / Middle Aged /
                      Aged / Cohort Studies / Aged, 80 and over / Risk Factors /
                      Proportional Hazards Models / Age Factors / cohort study
                      (Other) / epidemiology (Other) / parkinson's disease
                      (Other)},
      cin          = {AG Doblhammer},
      ddc          = {610},
      cid          = {I:(DE-2719)1012002},
      pnm          = {354 - Disease Prevention and Healthy Aging (POF4-354)},
      pid          = {G:(DE-HGF)POF4-354},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:39973480},
      doi          = {10.1177/1877718X241306132},
      url          = {https://pub.dzne.de/record/277791},
}