Parkinsonism is an umbrella term that refers to a set of symptoms related to movement. These motor symptoms include tremors, stiffness, slowness, and postural instability. Parkinsonism is most often caused by Parkinson’s disease.
Parkinson's disease is a specific neurodegenerative disorder caused by deficiencies in the neurotransmitter dopamine in certain regions of the brain (basal ganglia). It is chronic and progressive, meaning symptoms get worse over time.
Currently, over one million people in the U.S. are affected by Parkinson’s disease. People with Parkinson’s disease often experience both motor and non-motor symptoms. In some cases, patients experience non-motor symptoms, like loss of smell, before the onset of any motor symptoms.
Atypical Parkinson’s disease is a group of diseases that also cause parkinsonism symptoms. They are sometimes called Parkinson’s plus. These neurodegenerative diseases share similar symptoms with Parkinson’s disease but have distinct characteristics and progress differently. Examples include:
Secondary parkinsonism is when other conditions cause parkinsonism symptoms. These conditions include:
Parkinson's disease and parkinsonism affect people of all ages, races, and sexes. However, certain factors increase the risk of developing them, including:
Parkinson's disease and parkinsonism are diagnosed based upon a patient's medical history, physical exam, neurological exam, and family history. Presently, there is no single test for Parkinson's disease. However, the diagnosis may include blood tests or imaging studies such as CT scans, MRI, PET scans, or a DaTscan (Dopamine transporter scan).
There is currently no known cure for Parkinson's disease. Treatment focuses on managing symptoms and improving individuals’ quality of life with medications, physical and other therapies, and sometimes surgery.
Treatment for parkinsonism depends on the underlying cause of this condition. Most forms of secondary parkinsonism are treatable, and some may go into remission.
The state dashboard includes statewide prevalence with annual and trend data for Parkinson's disease and parkinsonism for adults aged 18 years and older, and by major socio-demographic factors (e.g., age group and sex).
The county dashboard includes regional and county prevalence for Parkinson’s disease and parkinsonism for adults aged 18 years and older. Data are visualized with maps, trend graphs, and data tables.
Coming soon
To create parkinsonism and Parkinson’s disease case indicators for the New York State Parkinson’s Disease Dashboard, we used New York State All-Payer Database (APD) data to identify members diagnosed with parkinsonism and Parkinson’s disease. We present these indicators by age group, sex, region, and residence county.
Public Health Law Section 2816 charges the New York State Department of Health to implement and maintain an APD. The New York APD is the single largest repository of health insurance claims data in the state. It includes claims from public (e.g., Medicaid and Medicare) and private/commercial payers providing insurance coverage to New York State residents. This includes Medicaid Managed Care, Medicaid Fee-for-Service, Medicare Fee-for-Service, Medicare Advantage, Qualified Health Plan, Essential Plan, Child Health Plus, and private/commercial plans.
The APD does not include claims from some federal insurance programs such as Tricare, Veterans' Affairs, and the Indian Health Service or from “self-funded” health plans created under the Employee Retirement Income Security Act of 1974, including the New York State Health Insurance Program's "Empire Plan" for public employees and employers. Additionally, the APD does not include claims from New Yorkers who are uninsured. Therefore, parkinsonism and Parkinson’s disease prevalence estimates do not include individuals who belong to insurance programs not included in the APD or who are uninsured. For the purpose of this analysis, the All-Payer claims data includes health plan enrollment and claims data. For more information about the All-Payer Database, please see: New York State All-Payer Database.
Each calendar year (January 1st – December 31st) of APD data from 2019 forward is referred to as a membership year. Individuals enrolled in the contributing health plans are referred to as members.
We calculated the following disease case indicators for each membership year:
To be counted in the denominator for any given membership year, members must meet the following inclusion criteria:
Numerators for the three disease case indicators (Parkinson’s disease, atypical Parkinson’s, and secondary parkinsonism) were calculated first based on grouping disease diagnoses (using ICD-10-CM Codes, Table 1).
The numerator for the Total parkinsonism and Parkinson’s disease indicator (the overall/combined total of the three indicators above) includes members meeting inclusion criteria for one or more of the disease case indicators mentioned above.
| Disease Indicator | ICD-10-CM Code | Description |
|---|---|---|
| Parkinson's disease | G20.0 | Parkinson's disease without dyskinesia |
| G20.A1 | Parkinson's disease without dyskinesia without mention of fluctuations | |
| G20.A2 | Parkinson's disease without dyskinesia with fluctuations | |
| G20.B1 | Parkinson's disease with dyskinesia without mention of fluctuations | |
| G20.B2 | Parkinson's disease with dyskinesia with fluctuations | |
| G20.C | Parkinsonism, unspecified | |
| Atypical Parkinson's disease | G13.8 | Systemic atrophy primarily affecting central nervous system in other diseases classified elsewhere |
| G23.2 | Striatonigral degeneration | |
| G23.3 | Hypomyelination with atrophy of the basal ganglia and cerebellum | |
| G90.3 | Multi-system degeneration of the autonomic nervous system | |
| G23.1 | Progressive supranuclear ophthalmoplegia | |
| G31.85 | Corticobasal degeneration | |
| G31.83 | Neurocognitive disorder with Lewy bodies | |
| Secondary parkinsonism | G21.0 | Malignant neuroleptic syndrome |
| G21.11 | Neuroleptic induced parkinsonism | |
| G21.19 | Other drug induced secondary parkinsonism | |
| G21.2 | Secondary parkinsonism due to other external agents | |
| G21.3 | Postencephalitic parkinsonism | |
| G21.4 | Vascular parkinsonism | |
| G21.8 | Other Secondary parkinsonism | |
| G21.9 | Secondary parkinsonism, unspecified |
To be counted in one or more of the indicator numerators, members must meet the following inclusion criteria:
| Membership Year | Eligible Claim Years (Membership Year or Year Prior) | ||||
|---|---|---|---|---|---|
| 2019 | 2018 | 2019 | |||
| 2020 | 2019 | 2020 | |||
| 2021 | 2020 | 2021 | |||
| 2022 | 2021 | 2022 | |||
Please Note:
The disease case indicators are not mutually exclusive. A member may meet criteria for and be counted towards more than one indicator numerator in a given membership year. For example, a member who met the criteria for both Parkinson’s disease and atypical Parkinson’s would be counted in each indicator numerator for that membership year. Therefore, we do not recommend summing numerators across multiple indicators.
Although members may meet criteria for and be counted towards more than one indicator numerator in a given membership year, members are only counted once towards the Total parkinsonism and Parkinson’s disease indicator numerator.
A member who meets numerator criteria in a given membership year may not be counted in subsequent membership years if they no longer meet indicator inclusion criteria in these subsequent years.
The overall prevalence for parkinsonism and Parkinson’s disease is low; therefore, we calculated the prevalence per 10,000 members (aged 18 years and older).
Prevalence for total parkinsonism and Parkinson’s disease, Parkinson’s disease, atypical Parkinson’s, and secondary parkinsonism for each membership year was calculated as (Numerator/Denominator)*10,000.
Prevalence estimates are presented overall and by age group, sex, region, and residence county. Prevalence estimates are suppressed (not displayed) if there are between 1 and 10 cases in the numerator.
Regional Schemas
Data are presented on this dashboard according to multiple regional/sub-regional schemas that group counties together into larger geographic regions of the state.
The Census Informed Sub-regional (CISR) schema was developed by the Office of Science (OS) Center for Population Health Science (CPHS) for visualization of population health data. The schema maintains the integrity of the Department’s four Regional Offices and their boundaries and is informed by core based statistical areas (CBSA) delineated every 10 years by the Office of Management and Budget. Please see this document for information on how the CISR schema was developed.
The Delivery System Reform Incentive Payment Program (DSRIP) schema was initially developed for the purpose of implementing the Medicaid Redesign Team (MRT) Waiver Amendment in New York State. Since then, the schema has been adopted for use by many other programs within the Department and is still used by New York State’s Medicaid program on their dashboards to visualize Medicaid utilization data even though the DSRIP Program ended in March 2020. For more information about the MRT, please see Redesigning New York's Medicaid Program.
Estimates for this analysis do not come from a longitudinal disease registry. They are rather produced by analyzing the New York State APD for serial cross-sectional results.
Numerator and denominator estimates reflect care received via health care enrollment and service claims, therefore, they are potentially impacted by access to care patterns and interruptions to access to care such as the COVID-19 pandemic. Additionally, because the APD does not include information from certain health insurance programs or from those who are not insured, these estimates may not reflect the true prevalence of parkinsonism and Parkinson’s disease among the general New York State adult population.
Member counts are based on unique values of an APD Member ID, which links members to information submitted by multiple insurers. While much effort is made to ensure correct linking, these counts may reflect more or fewer members identified with a unique ID than actual people covered.
Every effort has been made to limit the data to just New York State residents, but data may include data for out-of-state members if those individuals are enrolled in an insurance plan that is mandated by New York State legislation to submit data. These circumstances may be more common among older member populations who may be more likely to be enrolled in more than one type of insurance program or plan and/or more likely to live at multiple residences throughout the year.
If you have questions about the reports, please contact: phiginfo@health.ny.gov