Identifying individuals at-risk of developing Parkinson's disease using a population-based recruitment strategy: The Healthy Brain Ageing Kassel Study

Abstract

Neurodegeneration in Parkinson's disease (PD) occurs before motor features develop: assessing risk factors and identifying prodromal markers is necessary to recruit prodromal cohorts, improve early diagnosis, and develop preventive therapies. As part of Healthy Brain Ageing (HeBA), we implemented a stepwise, population-based screening to identify people at high risk of developing PD. Residents (n = 158,818; 50-80 years) in and around Kassel, Germany were invited to complete an online survey with questions for prodromal symptoms and risk factors. An individual risk score was calculated (International Parkinson and Movement Disorder Society criteria). Selected individuals received a smell test. 8001 of 8774 survey responses were valid; the response rate to the smell test mailings (n = 3021) was 90%. Hyposmic participants (n = 1019) had more subjective hyposmia and subjective memory impairment (p < 0.01). Follow-up visits will validate the recruitment strategy and monitor conversion to manifest PD. Our recruitment strategy identifies people who might be at risk for PD.

Fig. 1. Kassel study flowchart.

N number of participants, OND other neurological diseases, PD Parkinson’s disease, ALS amyotrophic lateral sclerosis, NPH normal pressure hydrocephalus, one pager includes items for year of birth, sex and five high-interest questions.

Fig. 2. Distribution of the calculated probability for prodromal Parkinson’s disease according to MDS criteria.

x-axis: calculated probability score in percent according to MDS criteria (Heinzel et al.) in 5% intervals for the entire cohort (left part) and 1% intervals for the cohort below 5% probability score (right part); y-axis: total count of participants with the respective probability score; MDS International Parkinson and Movement Disorder Society.