Paul and I will soon be off to Costa Rica, so I was curious about Parkinson’s in that country. First of all, I found that PD sounds much better in Spanish: Enfermedadde
Parkinson. Second, after much web searching, I found one advocacy organization out of Costa Rica’s capital for people with Parkinson’s , although the affected population is small enough that the advocacy organization also advocates for people with Alzheimer’s. The organization name is a mouthful (and kind of depressing when you translate it): ASOCIACIÓN COSTARRICENSE DE ALZHEIMER Y OTRAS DEMENCIAS ASOCIADAS (Costa Rican Association of Alzheimer’s and other Associated Dementias) or the much more graceful acronym of ASCADA.
How many people in Costa Rica are diagnosed with Parkinson’s? I could not find anything on this basic question, but then, there’s only a rough estimate (1 million) on the same question for the US. Using this rough estimate, approximately 0.3% of the US population is diagnosed with PD. So the guess for Costa Rica would 0.3% of its population of about 4.6 million would be a little under 14,000 people.
However, Costa Rica may have a higher percentage of people with PD. Why? Heavy pesticide use in banana/coffee plantations. (Pesticides are suspected as a contributing factor to PD.) One of the very few relevant web references I could find when I Googled “Costa Rica Parkinson’s Disease” was a feasibility study in 2013 to develop screening process for neurodegenerative disorders among the elderly. Scary results: For 401 subjects (all over 65), 33 were diagnosed with PD (8.2% of the research group!). The study abstract includes the sobering remark: “Based on international data, PD prevalence was 3.7 times higher than expected.”
So who will diagnose and treat Costa Ricans with PD? How many neurologists are there in Costa Rica? After some Internet research, I was not able to answer this question directly. However, my tour agency’s handy dandy reference book included the stat that Costa Rica has 1.32 physicians (of all kinds) per 1000 population.
How does this physician coverage contrast with the US? The equivalent number (all docs – specialists and primary care- per thousand) is 2.64, twice that of Costa Rica. However, I was shocked to find out how few neurologists there are in the US: estimated 16,366. Indeed, the American Academy of Neurology predicted a shortage: “The US could use 11 percent more neurologists to meet current needs. By 2025, that number will grow to 19 percent.” For the million folks with PD, the current estimate of neurologists translates to about 16 neurologists per 1000. Doesn’t sound too low, until you factor in that this is 1000 patients requiring ongoing treatment, not the population at large — and neurolgists are treating everything from epilepsy to migraines to the population tsunami that is Alzheimer’s (over 5 million and growing!). Hmmm…I believe a thank-you note to my excellent neurologist is merited!