Risk factors of Parkinson disease

Author:

Belvisi Daniele,Pellicciari Roberta,Fabbrini Andrea,Costanzo Matteo,Pietracupa Sara,De Lucia Maria,Modugno Nicola,Magrinelli FrancescaORCID,Dallocchio Carlo,Ercoli Tommaso,Terravecchia Claudio,Nicoletti Alessandra,Solla Paolo,Fabbrini Giovanni,Tinazzi Michele,Berardelli Alfredo,Defazio Giovanni

Abstract

ObjectiveTo perform a simultaneous evaluation of potential risk/protective factors of Parkinson disease (PD) to identify independent risk/protective factors, to assess interaction among factors, and to determine whether identified risk factors predict etiologic subtypes of PD.MethodsWe designed a large case-control study assessing 31 protective/risk factors of PD, including environmental and lifestyle factors, comorbid conditions, and drugs. The study enrolled 694 patients with PD and 640 healthy controls from 6 neurologic centers. Data were analyzed by logistic regression models, additive interaction models, and cluster analysis.ResultsThe simultaneous assessment of 31 putative risk/protective factors of PD showed that only coffee consumption (odds ratio [OR] 0.6; 95% confidence interval [CI] 0.4–0.9), smoking (OR 0.7, 95% CI 0.6–0.9), physical activity (OR 0.8, 95% CI 0.7–0.9), family history of PD (OR 3.2, 95% CI 2.2–4.8), dyspepsia (OR 1.8, 95% CI 1.3–2.4), and exposure to pesticides (OR 2.3, 95% CI1.3–4.2), oils (OR 5.6, 95% CI 2.3–13.7), metals (OR 2.8, 95% CI 1.5–5.4), and general anesthesia (OR 6.1, 95% CI 2.9–12.7) were independently associated with PD. There was no evidence of interaction among risk/protective factors, but cluster analysis identified 4 subtypes with different risk factor profiles. In group 1, all patients had a family history of PD, while dyspepsia or exposure to toxic agents was present in 30% of patients. In groups 2 and 3, a family history of PD was lacking, while exposure to toxic agents (group 2) and dyspepsia (group 3) played major roles. Group 4 consisted of patients with no risk factors.ConclusionsThis study demonstrated that 9 factors independently modify PD risk by coexisting in the same patient rather than interacting with others. Our study suggests the need for future preventive strategies aimed at reducing the coexistence of different risk factors within the same participant.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Neurology (clinical)

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