Objective: To determine the prevalence of Parkinson's disease in an urban area of Havana City province, Cuba.
Background: Parkinson's disease is one of the most frequent chronic neurodegenerative diseases in the elderly. Prevalence varies widely between different geographic areas and type of studies. To the author's knowledge, there are not epidemiological data on Parkinson's disease in Cuban population that allows a real estimation of the true magnitude of the disease.
Patients and methods: A "door-to-door" population study was carried out between November and December 1997. The area total population aged 15 years and over (n = 17.784) was interviewed and examined during the first phase of the study. This phase was performed by the 33 family doctors practicing in that area. An experienced neurologist previously trained the family doctors on making Parkinson's disease diagnosis. Diagnosis was based on the Brain Bank Society criteria. In order to make a definitive diagnosis of Parkinson's disease every subject that received such a diagnosis during the first phase was re-evaluated by two experienced neurologists. Those subjects with final diagnosis of Parkinson's disease were asked about family history of the disease. Prevalence rates were calculated according to sex, age group, color of the skin and smoking status.
Results: A total of 24 subjects received the final diagnosis of Parkinson's disease, yielding a population prevalence rate of 135 x 100,000 inhabitants. Eight subjects (33.3%) received a diagnosis of Parkinson's disease for the first time (de novo cases). Subjects with white color of the skin and non-smoking subjects showed a statistically significant higher prevalence of Parkinson's disease than subjects with non-white color of the skin and non-smokers respectively. Only 3 (12.5%) subjects reported a family history of Parkinson's disease.
Conclusion: The population of this area has a low prevalence rate of Parkinson's disease compared to that reported in other populations. The observed low frequency of family history of the disease suggests that the main determinants of Parkinson's disease are environmental factors yet to be identified.