Abstract
National studies of Parkinson’s disease (PD) provide critical data for healthcare planning, yet methodological limitations continue to undermine their utility. This review examines recent epidemiological work, including the Greek nationwide analysis, to highlight three priority areas for refinement: diagnostic accuracy, survival methodology, and recognition of disease heterogeneity. Misclassification due to reliance on ICD codes and overlap with drug-induced or vascular parkinsonism inflates prevalence estimates, while crude mortality measures fail to account for competing risks and comorbidities, exaggerating PD-specific risk. Stratification by age at onset remains underutilized despite clear genetic, clinical, and socioeconomic differences between early- and late-onset PD. Integrating administrative data with registries and biobanks, adopting digital biomarkers and AI-based diagnostic tools, and applying competing-risk and longitudinal survival models can generate more accurate and policy-relevant estimates. Equity considerations—ensuring representation of women, minorities, and rural populations—are essential for generalizable findings. Refining methodological standards in PD epidemiology is not only a technical necessity but also a prerequisite for equitable care, rational resource allocation, and progress in neurodegeneration research.
Keywords
Parkinson’s disease, Epidemiology, Diagnostic accuracy, Case ascertainment, Competing risk analysis, Survival models, Administrative data, Health disparities, Neurodegeneration, Public health policy