Early constipation predicts faster dementia onset in Parkinson’s disease

• 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; Nature Portfolio
• Subjects: 692/499; 692/617/375/1718; Biomedical and Life Sciences; Biomedicine; Constipation; Dementia; Neurology; Neurosciences; Parkinson's disease; Survival analysis
• ISSN: 2373-8057; 2373-8057
• DOI: 10.1038/s41531-021-00191-w

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.