Early constipation predicts faster dementia onset in Parkinson’s disease

Early constipation predicts faster dementia onset in Parkinson’s disease

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 cohort...

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Bibliographic Details
Published in:NPJ Parkinson's Disease Vol. 7; no. 1; pp. 45 - 7
Main Authors: Camacho, M., Macleod, A. D., Maple-Grødem, J., Evans, J. R., Breen, D. P., Cummins, G., Wijeyekoon, R. S., Greenland, J. C., Alves, G., Tysnes, O. B., Lawson, R. A., Barker, R. A., Williams-Gray, C. H.
Format: Journal Article
Language:English
Published: London Nature Publishing Group UK 26-05-2021
Nature Publishing Group
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Subjects:
692/499
692/617/375/1718
Biomedical and Life Sciences
Biomedicine
Constipation
Dementia
Neurology
Neurosciences
Parkinson's disease
Survival analysis
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Summary: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.
ISSN:2373-8057
2373-8057
DOI:10.1038/s41531-021-00191-w