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Meta-analysis of early nonmotor features and risk factors for Parkinson disease.
Ann Neurol 2012; 72(6):893-901AN

Abstract

OBJECTIVE

To evaluate the association between diagnosis of Parkinson disease (PD) and risk factors or early symptoms amenable to population-based screening.

METHODS

A systematic review and meta-analysis of risk factors for PD.

RESULTS

The strongest associations with later diagnosis of PD were found for having a first-degree or any relative with PD (odds ratio [OR], 3.23; 95% confidence interval [CI], 2.65-3.93 and OR, 4.45; 95% CI, 3.39-5.83) or any relative with tremor (OR, 2.74; 95% CI, 2.10-3.57), constipation (relative risk [RR], 2.34; 95% CI, 1.55-3.53), or lack of smoking history (current vs never: RR, 0.44; 95% CI, 0.39-0.50), each at least doubling the risk of PD. Further positive significant associations were found for history of anxiety or depression, pesticide exposure, head injury, rural living, beta-blockers, farming occupation, and well-water drinking, and negative significant associations were found for coffee drinking, hypertension, nonsteroidal anti-inflammatory drugs, calcium channel blockers, and alcohol, but not for diabetes mellitus, cancer, oral contraceptive pill use, surgical menopause, hormone replacement therapy, statins, acetaminophen/paracetamol, aspirin, tea drinking, history of general anesthesia, or gastric ulcers. In the systematic review, additional associations included negative associations with raised serum urate, and single studies or studies with conflicting results.

INTERPRETATION

The strongest risk factors associated with later PD diagnosis are having a family history of PD or tremor, a history of constipation, and lack of smoking history. Further factors also but less strongly contribute to risk of PD diagnosis or, as some premotor symptoms, require further standardized studies to demonstrate the magnitude of risk associated with them.

Authors+Show Affiliations

Institute of Neurology, University College London, London, United Kingdom.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Meta-Analysis
Review
Systematic Review

Language

eng

PubMed ID

23071076

Citation

Noyce, Alastair J., et al. "Meta-analysis of Early Nonmotor Features and Risk Factors for Parkinson Disease." Annals of Neurology, vol. 72, no. 6, 2012, pp. 893-901.
Noyce AJ, Bestwick JP, Silveira-Moriyama L, et al. Meta-analysis of early nonmotor features and risk factors for Parkinson disease. Ann Neurol. 2012;72(6):893-901.
Noyce, A. J., Bestwick, J. P., Silveira-Moriyama, L., Hawkes, C. H., Giovannoni, G., Lees, A. J., & Schrag, A. (2012). Meta-analysis of early nonmotor features and risk factors for Parkinson disease. Annals of Neurology, 72(6), pp. 893-901. doi:10.1002/ana.23687.
Noyce AJ, et al. Meta-analysis of Early Nonmotor Features and Risk Factors for Parkinson Disease. Ann Neurol. 2012;72(6):893-901. PubMed PMID: 23071076.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Meta-analysis of early nonmotor features and risk factors for Parkinson disease. AU - Noyce,Alastair J, AU - Bestwick,Jonathan P, AU - Silveira-Moriyama,Laura, AU - Hawkes,Christopher H, AU - Giovannoni,Gavin, AU - Lees,Andrew J, AU - Schrag,Anette, Y1 - 2012/10/15/ PY - 2012/05/11/received PY - 2012/06/19/revised PY - 2012/07/06/accepted PY - 2012/10/17/entrez PY - 2012/10/17/pubmed PY - 2013/2/26/medline SP - 893 EP - 901 JF - Annals of neurology JO - Ann. Neurol. VL - 72 IS - 6 N2 - OBJECTIVE: To evaluate the association between diagnosis of Parkinson disease (PD) and risk factors or early symptoms amenable to population-based screening. METHODS: A systematic review and meta-analysis of risk factors for PD. RESULTS: The strongest associations with later diagnosis of PD were found for having a first-degree or any relative with PD (odds ratio [OR], 3.23; 95% confidence interval [CI], 2.65-3.93 and OR, 4.45; 95% CI, 3.39-5.83) or any relative with tremor (OR, 2.74; 95% CI, 2.10-3.57), constipation (relative risk [RR], 2.34; 95% CI, 1.55-3.53), or lack of smoking history (current vs never: RR, 0.44; 95% CI, 0.39-0.50), each at least doubling the risk of PD. Further positive significant associations were found for history of anxiety or depression, pesticide exposure, head injury, rural living, beta-blockers, farming occupation, and well-water drinking, and negative significant associations were found for coffee drinking, hypertension, nonsteroidal anti-inflammatory drugs, calcium channel blockers, and alcohol, but not for diabetes mellitus, cancer, oral contraceptive pill use, surgical menopause, hormone replacement therapy, statins, acetaminophen/paracetamol, aspirin, tea drinking, history of general anesthesia, or gastric ulcers. In the systematic review, additional associations included negative associations with raised serum urate, and single studies or studies with conflicting results. INTERPRETATION: The strongest risk factors associated with later PD diagnosis are having a family history of PD or tremor, a history of constipation, and lack of smoking history. Further factors also but less strongly contribute to risk of PD diagnosis or, as some premotor symptoms, require further standardized studies to demonstrate the magnitude of risk associated with them. SN - 1531-8249 UR - https://www.unboundmedicine.com/medline/citation/23071076/full_citation L2 - https://doi.org/10.1002/ana.23687 DB - PRIME DP - Unbound Medicine ER -