1. Early constipation predicts faster dementia onset in Parkinson’s disease
- Author
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David P. Breen, Gemma Cummins, Marta Camacho, Jonathan R. Evans, Julia C. Greenland, Guido Alves, Ole-Bjørn Tysnes, Ruwani Wijeyekoon, Roger A. Barker, Rachael A Lawson, Jodi Maple-Grødem, Caroline H. Williams-Gray, Angus D. Macleod, Camacho, M. [0000-0002-1490-5703], Macleod, A. D. [0000-0002-6284-4239], Maple-Grødem, J. [0000-0001-7142-0078], Alves, G. [0000-0003-0630-2870], Barker, R. A. [0000-0001-8843-7730], Apollo - University of Cambridge Repository, Camacho, M [0000-0002-1490-5703], Macleod, AD [0000-0002-6284-4239], Maple-Grødem, J [0000-0001-7142-0078], Alves, G [0000-0003-0630-2870], Barker, RA [0000-0001-8843-7730], Macleod, A D [0000-0002-6284-4239], and Barker, R A [0000-0001-8843-7730]
- Subjects
0301 basic medicine ,Aging ,692/617/375/1718 ,Parkinson's disease ,Constipation ,5202 Biological Psychology ,32 Biomedical and Clinical Sciences ,Neurodegenerative ,forstoppelse ,0302 clinical medicine ,5204 Cognitive and Computational Psychology ,2.1 Biological and endogenous factors ,Parkinson ,2 Aetiology ,Parkinson's Disease ,Incidence (epidemiology) ,Confounding ,article ,Neurology ,52 Psychology ,Neurological ,medicine.symptom ,692/499 ,4.2 Evaluation of markers and technologies ,medicine.medical_specialty ,03 medical and health sciences ,Cellular and Molecular Neuroscience ,Clinical Research ,Internal medicine ,medicine ,Acquired Cognitive Impairment ,Dementia ,demens ,RC346-429 ,Survival analysis ,business.industry ,Proportional hazards model ,FOS: Clinical medicine ,Neurosciences ,Medisinske Fag: 700::Klinisk medisinske fag: 750::Nevrologi: 752 [VDP] ,medicine.disease ,Brain Disorders ,4.1 Discovery and preclinical testing of markers and technologies ,nevrologi ,030104 developmental biology ,Risk factors ,3209 Neurosciences ,Neurology (clinical) ,Neurology. Diseases of the nervous system ,business ,4 Detection, screening and diagnosis ,030217 neurology & neurosurgery - Abstract
Constipation is a common but not a universal feature in early PD, suggesting that gut involvement is heterogeneous and may be part of a distinct PD subtype with prognostic implications. We analysed data from the Parkinson’s Incidence Cohorts Collaboration, composed of incident community-based cohorts of PD patients assessed longitudinally over 8 years. Constipation was assessed with the MDS-UPDRS constipation item or a comparable categorical scale. Primary PD outcomes of interest were dementia, postural instability and death. PD patients were stratified according to constipation severity at diagnosis: none (n = 313, 67.3%), minor (n = 97, 20.9%) and major (n = 55, 11.8%). Clinical progression to all three outcomes was more rapid in those with more severe constipation at baseline (Kaplan–Meier survival analysis). Cox regression analysis, adjusting for relevant confounders, confirmed a significant relationship between constipation severity and progression to dementia, but not postural instability or death. Early constipation may predict an accelerated progression of neurodegenerative pathology.
- Published
- 2021