Midlife vascular risk factors, Parkinson’s disease, and Parkinson’s disease-dementia in the Atherosclerosis Risk in Communities (ARIC) cohort

Authors

• M Johri
• V Morrill
• DN Okine
• J Seemiller
• KJ Sullivan
• L Rosenthal
• S Shrestha
• RF Gottesman
• H Chen

Abstract

Background: Vascular risk factors like hypertension, smoking, obesity, and diabetes are associated with dementia, but their importance in other neurodegenerative disorders like Parkinson’s disease (PD) and PD-dementia is less well understood. This study explores whether midlife vascular risk factors are associated with a higher risk of PD and PD-dementia in the Atherosclerosis Risk in Communities (ARIC) cohort.

Methods: Cases of PD were adjudicated through 2016 by reviewing participant medications, self-reported physician-made diagnoses, and hospitalization and death surveillance from cohort follow-up. Cox proportional hazards models were used to examine associations between midlife vascular risk factors with PD and with PD-dementia, PD alone, dementia alone, relative to no PD-no dementia. Models included all risk factors together adjusted for age, race/center, sex, and education level. Secondary analyses evaluated effect modification by race and sex in stratified models.

Results: Out of an analytic sample of 14,747, a total of 208 (1.41%) of participants developed incident PD. Smoking (HR 0.38, 95% CI 0.23-0.61) was significantly associated with a lower PD rate and a lower PD-dementia rate (HR 0.37, 95% CI 0.23-0.60). Women were less likely to develop PD than men (HR 0.49, 95% CI 0.37-0.67). Vascular risk factors had similar associations with PD and PD-dementia in race subgroups.

Conclusion: Smoking status in midlife was associated with lower rates of PD and PD-dementia. Further studies should evaluate changes of these vascular risk factors over the life course and continue to explore mechanisms for the observed associations.

Scientific Focus Area: Epidemiology

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