Age distribution of Dupuytren's contracture, influence of gender
Dupuytren's disease typically starts at the ages of 30 to 40, though even children have been reported to suffer from Dupuytren's disease (example of a 10 year old boy: "Dupuytren's disease in a child: a case report" Dupuytren_child_abstract). In Germany, it is estimated that about 20 percent of the male population over the age of 50 suffer from Dupuytrens, while 40 percent over the age of 80 are affected. In absolute terms, this amounts to a lot of people: in Germany alone the number of sufferers is estimated to 1.3 - 1.9 million people (though such estimates are difficult to verify).
Fig reprinted with permission of Elsevier from Douglas Ross "Epidemiology of Dupuytren's Disease" in R. Tubiana and G. Rayan (Eds.) "Dupuytren's Disease" Hand Clinics 15 (1999).
Research papers often report that men acquire Dupuytren's disease x times more often than women with x varying between 2 and 9. Those data typically result from counting patients who get treated for Dupuytren's contracture and may be somewhat misleading. The above picture shows that the onset of Dupuytren's contracture is typically 10 - 20 years earlier for males, with men at the ages of 30 - 40 acquiring it about 6 - 8 times more often than women. This results in more men getting treated which in turn creates the reported relations.
The reason why Dupuytren's starts earlier for men is unclear. One of the few papers assessing this aspect is e.g. A. Pagnotta et al. "Androgen receptors in Dupuytren's contracture" J. Orthop. Res. 20 (2002) 163-168 abstract. Different from the picture shown above, research indicates that above the age of 80 the percent affected is about even for men and women (see e.g. the thesis of J.P. Moermans, Mikkelsen in the above cited paper find a male:female ration of 1.2 : 1 for age 85 - 89). Men are suffering from progressed stages due to the earlier onset. S. Anthony at al. "Gender Ratio of Dupuytren's Disease in the Modern U.S. Population" analyze data in the Boston, USA, area finding that "the ratio approached 1:1 with increasing age" abstract.
Some results even indicate a lower percentage for men above 80 which is explained by an increased mortality of Dupuytren patients (see Wilbrand et al (2005), Gudmundsson et al (2002), and Mikkelsen et al. (1999) ). The reason for this inreased mortality, if it exists, remains unclear.
Geographic distribution of Dupuytren's disease
Probably due to genetic factors, there are also geographic variations. Dupuytren's contracture is frequent in Middle and Northern Europe, in Australia, and in North America. It exists but is, probably, less frequent in Africa and Asia, though recently Dupyutren's patients have been reported in Japan, China, Africa, and India. Examples: G.I. Muguti and B Appelt "Dupuytren's contracture in black Zimbabweans" Cent Afr J Med 36 (1993) p 129 - 132; and S. Srivastava, J.D. Nancarrow, D.F. Cort "Dupuytren's disease in patients from the Indian sub-continent. Report of ten cases." J Hand Surg [Br] 14 (1989) p 32-4 "We believe that Dupuytren's disease among Indians is not so rare as previously thought.", and H. S. Cheng et al. "Needle aponeurotomy for Dupuytren's contracture." J. Othoped. Surgery (Hong Kong) 16 (2008) p 88-90.
While on average about 1-3 percent of the total population in Western industrial countries are affected, the percentage varies between countries and is very high e.g. in Australia, France, Ireland, and Scotland with 17 percent of the total population. Additionally, the percentage increases with age. In the USA, it is estimated that approximately 25% of middle-aged or elderly individuals develop palmar or plantar contracture (Dupuytren's contracture or Ledderhose's disease,respectively, source: emedicine). The picture below shows percentages of the population with Dupuytren's in various countries, with high percentages e.g. also in Spain and Japan, thus disproving the theory that Dupuytren's contracture is a Viking or Celtic disease (see also R. McFarlane "On the origin and spread of Dupuytren's disease" J. Hand Surg. (Am) 27 (2002) p385-390 link_abstract). Note that the percentage depends on the avarage age of the samples which is not the same for all countries in the figure below.
Fig reprinted with permission of Elsevier from Douglas Ross "Epidemiology of Dupuytren's Disease" in R. Tubiana and G. Rayan (Eds.) "Dupuytren's Disease" Hand Clinics 15 (1999) p 55.
Missing reports on Dupuytren's contracture e.g. in Mediterranian populations may be in part due to missing studies. A recent survey of Bosnia-Herzegovina showed very high prevalence in the Croatian and Serbian population (up to 75 percent for men above the age of 75) and low prevalence for the Muslim population. "However, as there are no true ethnic differences between the populations of Bosnia and Herzegovina, only religious and social differences, it is surprising to find lower prevalence among Bosnian Muslim than Bosnian Serb and Croat men. It is possible that this is a spurious finding, particularly as no such difference was found among women, but it may also be due to some, as yet undetermined, difference in social factors." Full_text_Dupuytrens_Bosnia.
Further reading:
Overview of Dupuytren's disease
Stages and therapies of Dupuytren's disease
Literature on Dupuytren's disease
Page last modified:
09/19/2008