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TITLE: Association of coffee and caffeine intake with the risk of Parkinson disease.
AUTHORS: Ross GW; Abbott RD; Petrovitch H; Morens DM; Grandinetti A; Tung KH; Tanner CM; Masaki KH; Blanchette PL; Curb JD; Popper JS; White LR
AUTHOR AFFILIATION: Department of Veterans Affairs, Honolulu (151), PO Box 50188, Honolulu, HI 96850, USA. ross@phri.hawaii-health.com
SOURCE: JAMA 2000 May 24-31;283(20):2674-9
CITATION IDS: PMID: 10819950 UI: 20280048
ABSTRACT: CONTEXT: The projected expansion in the next several decades of the elderly population at highest risk for Parkinson disease (PD) makes identification of factors that promote or prevent the disease an important goal.

OBJECTIVE: To explore the association of coffee and dietary caffeine intake with risk of PD.

DESIGN, SETTING, AND PARTICIPANTS: Data were analyzed from 30 years of follow-up of 8004 Japanese-American men (aged 45-68 years) enrolled in the prospective longitudinal Honolulu Heart Program between 1965 and 1968.

MAIN OUTCOME MEASURE: Incident PD, by amount of coffee intake (measured at study enrollment and 6-year follow-up) and by total dietary caffeine intake (measured at enrollment).

RESULTS: During follow-up, 102 men were identified as having PD. Age-adjusted incidence of PD declined consistently with increased amounts of coffee intake, from 10.4 per 10,000 person-years in men who drank no coffee to 1.9 per 10,000 person-years in men who drank at least 28 oz/d (P<.001 for trend). Similar relationships were observed with total caffeine intake (P<.001 for trend) and caffeine from non-coffee sources (P=.03 for trend). Consumption of increasing amounts of coffee was also associated with lower risk of PD in men who were never, past, and current smokers at baseline (P=.049, P=.22, and P=.02, respectively, for trend). Other nutrients in coffee, including niacin, were unrelated to PD incidence. The relationship between caffeine and PD was unaltered by intake of milk and sugar.

CONCLUSIONS: Our findings indicate that higher coffee and caffeine intake is associated with a significantly lower incidence of PD. This effect appears to be independent of smoking. The data suggest that the mechanism is related to caffeine intake and not to other nutrients contained in coffee. JAMA. 2000;283:2674-2679.

2000/06
2000/10 09:00


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TITLE: Parkinson disease survival: a population-based study.
AUTHORS: Morgante L; Salemi G; Meneghini F; Di Rosa AE; Epifanio A; Grigoletto F; Ragonese P; Patti F; Reggio A; Di Perri R; Savettieri G
AUTHOR AFFILIATION: Department of Neurology, University of Messina, Italy.
SOURCE: Arch Neurol 2000 Apr;57(4):507-12
CITATION IDS: PMID: 10768625 UI: 20229112
ABSTRACT: OBJECTIVE: To evaluate whether the survival of patients with Parkinson disease (PD) is shorter than that of the general population.

DESIGN: Survival was investigated in a cohort of patients with PD previously identified during a population-based prevalence study (prevalence day, November 1, 1987, reference follow-up date, October 31, 1995). The survival of patients with PD was compared with that of a control sample randomly selected from the same population (2 controls for each case, matched for age, sex, and study municipality). The causes of death in the 2 groups were also compared. Both univariate and multivariate survival analyses were performed to investigate the association with disease-related variables.

SETTING: A door-to-door 2-phase prevalence survey performed in 3 Sicilian municipalities.

PATIENTS: Fifty-nine patients with PD and 118 controls. RESULTS: Patients with PD showed a high risk of death (relative risk, 2.3; 95% confidence interval, 1.60-3.39). Greater age at November 1, 1987, high Hoehn-Yahr score, and lack of levodopa therapy were associated with a lower survival on univariate analysis. Multivariate analysis confirmed the association between shorter survival among patients with PD and greater age on November 1, 1987. One-way analysis of variance indicated a different effect of levodopa therapy according to age. Multivariate analysis did not confirm this finding. Pneumonia was the cause of death most frequently associated with PD.

CONCLUSION: This study indicates that patients with PD have a shorter survival time than the general population.

2000/04
2000/29 09:00


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TITLE: A 10-year study of the incidence of and factors predicting dementia in Parkinson's disease.
AUTHORS: Hughes TA; Ross HF; Musa S; Bhattacherjee S; Nathan RN; Mindham RH; Spokes EG
AUTHOR AFFILIATION: Division of Psychiatry and Behavioural Sciences, University of Leeds, UK.
SOURCE: Neurology 2000 Apr 25;54(8):1596-602
CITATION IDS: PMID: 10762499 UI: 20227863
ABSTRACT: OBJECTIVE: To compare the incidence of dementia in PD with that of a control group without PD, and to assess the relationship between dementia and other features of PD.

METHODS: The authors recruited 83 patients with PD and 50 controls, all without dementia at initial assessment, and assessed them at regular intervals over a maximum period of 122 months. Dementia was diagnosed according to objective criteria, and included a judgment by researchers masked to subject group and to variables putatively associated with dementia.

RESULTS: Seventeen patients fulfilled dementia criteria; no controls did so. The cumulative proportion of PD patients becoming demented by 112 months was 0.38 (95% CI 0.20 to 0.55), or 42.6 cases per 1000 years of observation. Univariate analyses showed that incident dementia in patients with PD was associated with older age at entry into the study, greater severity of neurologic symptoms, longer duration of PD, greater disability, and male sex. The association of age at onset of PD with incident dementia was of only borderline significance. Multivariate analysis found that age at entry into the study and severity of motor symptoms were significant predictors of dementia but duration of PD and age at onset of PD were not.

CONCLUSIONS: Dementia in PD is likely to reflect interaction of the neuropathology of the basal ganglia and age-related pathology. The findings do not support the division of PD into early and late-onset cases.

2000/05
2000/20 09:00


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TITLE: Assessment of voiding dysfunction in Parkinson's disease by the international prostate symptom score.
AUTHORS: Araki I; Kuno S
AUTHOR AFFILIATION: Department of Urology, Utano National Hospital, Kyoto, Japan. iaraki@utano.hosp.go.jp
SOURCE: J Neurol Neurosurg Psychiatry 2000 Apr;68(4):429-33
CITATION IDS: PMID: 10727477 UI: 20193714
ABSTRACT: OBJECTIVES: To find the incidence of voiding dysfunction in Parkinson's disease and to examine the relation between the voiding dysfunction and various indices of the disease (disease severity, disease duration, age, sex, and treatment with antiparkisonian drugs), the presence of voiding dysfunction was quantitatively estimated in patients sampled on the unselected (consecutive) basis.

METHODS: Using the international prostate symptom score, lower urinary tract symptoms were quantitatively evaluated in all patients with Parkinson's disease visiting this neurological clinic during 1 month.

RESULTS: Of the 203 patients who had completed the questionnaire, 55 (27%) were considered to have symptomatic voiding dysfunction. The degree of lower urinary tract symptoms in these patients was well correlated with the severity of the disease rather than with the disease duration or the age. Thirty three (16%) patients had irritative symptoms alone, whereas three (1.5%) patients had obstructive symptoms alone. The irritative and obstructive symptoms were concomitant in 13 (6%) patients. Quality of life was disturbed by lower urinary tract symptoms, and this disturbance paralleled the severity of the disease. The influence of antiparkisonian drugs on the lower urinary tract symptoms was uncertain. The incidence of lower urinary tract symptoms seemed to be independent of sex, but obstructive symptoms were prevalent in male patients.

CONCLUSIONS: This study suggests that voiding dysfunction in patients with Parkinson's disease progressively develops at advanced stages (> or =Hoehn and Yahr stage 3 of the disability). The International prostate symptom score is useful in evaluating the voiding dysfunction of neurodegenerative disease in both men and women, not only reflecting prostatic symptoms.

2000/06
2000/10 09:00


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TITLE: Adult nutrient intake as a risk factor for Parkinson's disease.
AUTHORS: Johnson CC; Gorell JM; Rybicki BA; Sanders K; Peterson EL
AUTHOR AFFILIATION: Department of Biostatistics and Research Epidemiology, Henry Ford Health System, Detroit, Michigan, USA.
SOURCE: Int J Epidemiol 1999 Dec;28(6):1102-9
CITATION IDS: PMID: 10661654 UI: 20125296
ABSTRACT: BACKGROUND: This population-based case-control study evaluated nutrient intake as a risk factor for Parkinson's disease (PD) among people aged > or =50 years in metropolitan Detroit.

METHODS: Cases (n = 126) were diagnosed between 1991 and 1995 and neurologist-confirmed. Controls (n = 432) were frequency-matched for sex, age (+/-5 years) and race. Using a standardized food frequency questionnaire, subjects reported the foods they ate within the past year.

RESULTS: Estimating the association between PD and risk of being in the highest versus the lowest intake quartile, there were elevated odds ratios for total fat (OR 1.94, 95% confidence interval [CI] : 1.05-3.58), cholesterol (OR 2.11, 95% CI: 1.14-3.90), lutein (OR 2.52, 95% CI: 1.32-4.84) and iron (OR 1.88, 95% CI: 1.05-3.38).

CONCLUSIONS: These results suggest an association of PD with high intake of total fat, saturated fats, cholesterol, lutein and iron.

2000/03
2000/04 09:00


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TITLE: Risk factors for levodopa-induced dyskinesias in Parkinson's disease.
AUTHORS: Grandas F; Galiano ML; Tabernero C
AUTHOR AFFILIATION: Servicio de Neurologia, Hospital General Universitario Gregorio Maranon, Madrid, Spain.
SOURCE: J Neurol 1999 Dec;246(12):1127-33
CITATION IDS: PMID: 10653303 UI: 20117028
ABSTRACT: To identify putative risk factors for levodopa-induced dyskinesias we studied the effect of several clinical variables on the occurrence of dyskinesias in a series of 168 consecutive patients with Parkinson's disease treated for at least 6 months with levodopa. Of these, 108 (64%) developed dyskinesias after a mean duration of levodopa treatment of 51.4 +/- 43.3 months. Patients tended to suffer dyskinesias on the side of the body first affected by Parkinson's disease. The overall probability of developing dyskinesias increased with levodopa treatment duration, about 10% per year during the first 7 years. Univariate and multivariate logistic regression analysis identified the age at onset of Parkinson's disease (OR 0.923; 95% CI 0.883-0.964) and the initial levodopa dose (mean dose of the first 6 months of treatment; OR 1.004; 95% CI 1.002-1.006) as the main independent predictors. Survival curves showed that onset of Parkinson's disease at age 50 years or before (logrank, P < 0.05) and initial levodopa treatment with more than 600 mg/day (logrank, P < 0.05) were associated with a higher risk for the appearance of dyskinesias.

2000/02
2000/01 09:00


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TITLE: Mortality from Parkinson's disease and other causes in men who were prisoners of war in the Far East [see comments]
AUTHORS: Gale CR; Braidwood EA; Winter PD; Martyn CN
AUTHOR AFFILIATION: Medical Research Council Environmental Epidemiology Unit, University of Southampton, Southampton General Hospital, UK.
SOURCE: Lancet 1999 Dec 18-25;354(9196):2116-8
CITATION IDS: PMID: 10609817 UI: 20075908
COMMENT: Comment in: Lancet 2000 Mar 4;355(9206):843
ABSTRACT: BACKGROUND: During World War II, more than 140000 Allied prisoners of war (POWs) were held captive by the Japanese in conditions of extreme privation. There have been concerns that the survivors are at increased risk of degenerative neurological disorders, especially Parkinson's disease. We assembled a cohort of British ex-POWs and analysed their mortality in a 46-year follow-up study.

METHODS: Using records held by the War Pensions Agency, we abstracted data on 11915 British former POWs. 11134 men were traced, and observed numbers of deaths between 1952 and 1997 were compared with those expected from national rates for the male population of England and Wales. Standardised mortality ratios (SMR) were calculated.

FINDINGS: Overall, mortality was lower than expected (7474 deaths vs 8796.2 expected; SMR 0.85 [95% CI 0.83-0.87]). Death rates from Parkinson's disease among the former POWs were slightly below the national average, though this difference was not statistically significant (35 deaths vs 43.2 expected; SMR 0.81 [0.56-1.13]). A similar pattern was seen for other degenerative neurological disorders (motorneuron disease 0.62 [0.31-1.11], multiple sclerosis 0.88 [0.42-1.61], and dementia 0.88 [0.68-1.11]). The former POWs had significantly lower than expected mortality from all major causes of death (ischaemic heart disease 0.81 [0.78-0.85], cerebrovascular disease 0.88 [0.81-0.95], all malignant neoplasms 0.92 [0.88-0.95], and respiratory disease 0.79 [0.74-0.85]). They also had below average rates of death from tuberculosis (0.44 [0.26-0.71]) and suicide (0.77 [0.57-1.02]), though the latter relation was not statistically significant. Mortality from diseases of the liver was increased (chronic liver disease and cirrhosis 1.68 [1.28-2.17], primary carcinoma of the liver 2.42 [1.75-3.26]).

INTERPRETATION: There is little evidence that men who were POWs in the Far East have higher rates of death than the male population generally. The only exception is diseases of the liver, which may be due to infection with hepatitis B or C virus during captivity. Death-certification data cannot provide a complete picture of physical and mental health, but the period of severe malnutrition, frequent infections, exhaustion, and intense psychological stress seems not to have increased susceptibility to neurodegenerative disease.

1999/12
1999/28 09:00



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