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Nationwide Geographic Cluster Analysis of Incident Parkinson’s Disease

Study Rationale:
The causes of Parkinson’s disease (PD) are mostly unknown, but non-genetic factors, such as environmental exposures during one’s lifetime, probably affect whether a person develops PD. Geographic clusters of PD represent areas of the United States where more people develop PD than expected, and these clusters can provide clues about environmental causes of PD.

We hypothesize that many geographic clusters of PD exist across the U.S. and that these clusters will share similar environmental characteristics, such as certain types of air pollution, which we can identify and study as PD risk factors.

Study Design:
We will use data from more than 22 million Medicare recipients to find geographic clusters of people newly diagnosed with PD. We then will identify environmental features that are more common in these areas, as compared to the rest of the U.S., and then formally investigate whether risk of PD is associated with these features.

Impact on Diagnosis/Treatment of Parkinson’s Disease:
The goal of this project is to identify environmental exposures that, if addressed through policy changes and education, could reduce the number of people who are ultimately diagnosed with PD.

Next Steps for Development:
Identification of environmental exposures that contribute to PD will lead to research to explore the biology of these environmental toxins to better understand how they contribute to the characteristic brain degeneration seen in PD.


  • Susan Searles Nielsen, PhD

    St. Louis, MO United States

  • Brad A. Racette, MD

    St. Louis, MO United States

  • Jay Turner, DSc

    St. Louis, MO United States

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