Journal
NPJ PARKINSONS DISEASE
Volume 7, Issue 1, Pages -Publisher
NATURE PORTFOLIO
DOI: 10.1038/s41531-021-00191-w
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Categories
Funding
- Chief Scientist Office of the Scottish Government
- NHS Education for Scotland
- Academy of Medical Sciences
- Cure Parkinson's Trust
- Van Geest Foundation
- Medical Research Council (MRC)
- Parkinson's UK [F-1801]
- National Institute for Health Research (NIHR) Cambridge Biomedical Research Centre Dementia and Neurodegeneration Theme [146281]
- Centre for Parkinson's Plus
- Evelyn Trust [19/24]
- Wellcome Trust Stem Cell Institute (Cambridge) [203151/Z/16/Z]
- Wellcome Clinical Research Career Development Fellowship [214571/Z/18/Z]
- RCUK/UKRI Research Innovation Fellowship - MRC [MR/R007446/1]
- Cambridge Centre for Parkinson-Plus
- Research Council of Norway [177966, 287842]
- Western Norway Regional Health Authority [911218]
- Norwegian Parkinson's Disease Association
- Wellcome Trust [214571/Z/18/Z] Funding Source: Wellcome Trust
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Constipation severity in early Parkinson's disease is significantly associated with progression to dementia, indicating that constipation may predict accelerated neurodegenerative pathology.
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.
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