Integration of risk factors for Parkinson disease in 2 large longitudinal cohorts

Iris Y. Kim, Éilis J. O'Reilly, Katherine C. Hughes, Xiang Gao, Michael A. Schwarzschild, Marian T. Hannan, Rebecca Betensky, Alberto Ascherio

Research output: Contribution to journalArticle

Abstract

OBJECTIVE: To prospectively examine how selected lifestyle factors and family history of Parkinson disease (PD) combine to determine overall PD risk. METHODS: We derived risk scores among 69,968 women in the Nurses' Health Study (NHS) (1984-2012) and 45,830 men in the Health Professionals Follow-up Study (HPFS) (1986-2012). Risk scores were computed for each individual based on the following factors previously associated with PD risk: total caffeine intake, smoking, physical activity, and family history of PD for the NHS, and additionally total flavonoid intake and dietary urate index for the HPFS. Hazard ratios were estimated using Cox proportional hazards models. In addition, we performed tests of interactions on both the multiplicative and additive scale between pairs of risk factors. RESULTS: We documented 1,117 incident PD cases during follow-up. The adjusted hazard ratios comparing individuals in the highest category of the reduced risk score to those in the lowest category were 0.33 (95% confidence interval: 0.21, 0.49; ptrend < 0.0001) in the NHS and 0.18 (95% confidence interval: 0.10, 0.32; ptrend < 0.0001) in the HPFS. Results were similar when applying the risk scores computed by summing the predictors weighted by the log of their individual effect sizes on PD risk in these cohorts. Additive interaction was present between no family history of PD and caffeine in men and between caffeine and physical activity in women. CONCLUSIONS: Our results suggest that known protective factors for PD tend to have additive or superadditive effects, so that PD risk is very low in individuals with multiple protective risk factors.

Original languageEnglish (US)
Pages (from-to)e1646-e1653
JournalNeurology
Volume90
Issue number19
DOIs
StatePublished - May 8 2018

Fingerprint

Parkinson Disease
Caffeine
Health
Nurses
Confidence Intervals
Exercise
Men's Health
Uric Acid
Proportional Hazards Models
Flavonoids
Life Style
Smoking

ASJC Scopus subject areas

  • Clinical Neurology

Cite this

Kim, I. Y., O'Reilly, É. J., Hughes, K. C., Gao, X., Schwarzschild, M. A., Hannan, M. T., ... Ascherio, A. (2018). Integration of risk factors for Parkinson disease in 2 large longitudinal cohorts. Neurology, 90(19), e1646-e1653. https://doi.org/10.1212/WNL.0000000000005473

Integration of risk factors for Parkinson disease in 2 large longitudinal cohorts. / Kim, Iris Y.; O'Reilly, Éilis J.; Hughes, Katherine C.; Gao, Xiang; Schwarzschild, Michael A.; Hannan, Marian T.; Betensky, Rebecca; Ascherio, Alberto.

In: Neurology, Vol. 90, No. 19, 08.05.2018, p. e1646-e1653.

Research output: Contribution to journalArticle

Kim, IY, O'Reilly, ÉJ, Hughes, KC, Gao, X, Schwarzschild, MA, Hannan, MT, Betensky, R & Ascherio, A 2018, 'Integration of risk factors for Parkinson disease in 2 large longitudinal cohorts', Neurology, vol. 90, no. 19, pp. e1646-e1653. https://doi.org/10.1212/WNL.0000000000005473
Kim IY, O'Reilly ÉJ, Hughes KC, Gao X, Schwarzschild MA, Hannan MT et al. Integration of risk factors for Parkinson disease in 2 large longitudinal cohorts. Neurology. 2018 May 8;90(19):e1646-e1653. https://doi.org/10.1212/WNL.0000000000005473
Kim, Iris Y. ; O'Reilly, Éilis J. ; Hughes, Katherine C. ; Gao, Xiang ; Schwarzschild, Michael A. ; Hannan, Marian T. ; Betensky, Rebecca ; Ascherio, Alberto. / Integration of risk factors for Parkinson disease in 2 large longitudinal cohorts. In: Neurology. 2018 ; Vol. 90, No. 19. pp. e1646-e1653.
@article{52244c7c3dd34a9c80b3c5c10abbcc09,
title = "Integration of risk factors for Parkinson disease in 2 large longitudinal cohorts",
abstract = "OBJECTIVE: To prospectively examine how selected lifestyle factors and family history of Parkinson disease (PD) combine to determine overall PD risk. METHODS: We derived risk scores among 69,968 women in the Nurses' Health Study (NHS) (1984-2012) and 45,830 men in the Health Professionals Follow-up Study (HPFS) (1986-2012). Risk scores were computed for each individual based on the following factors previously associated with PD risk: total caffeine intake, smoking, physical activity, and family history of PD for the NHS, and additionally total flavonoid intake and dietary urate index for the HPFS. Hazard ratios were estimated using Cox proportional hazards models. In addition, we performed tests of interactions on both the multiplicative and additive scale between pairs of risk factors. RESULTS: We documented 1,117 incident PD cases during follow-up. The adjusted hazard ratios comparing individuals in the highest category of the reduced risk score to those in the lowest category were 0.33 (95{\%} confidence interval: 0.21, 0.49; ptrend < 0.0001) in the NHS and 0.18 (95{\%} confidence interval: 0.10, 0.32; ptrend < 0.0001) in the HPFS. Results were similar when applying the risk scores computed by summing the predictors weighted by the log of their individual effect sizes on PD risk in these cohorts. Additive interaction was present between no family history of PD and caffeine in men and between caffeine and physical activity in women. CONCLUSIONS: Our results suggest that known protective factors for PD tend to have additive or superadditive effects, so that PD risk is very low in individuals with multiple protective risk factors.",
author = "Kim, {Iris Y.} and O'Reilly, {{\'E}ilis J.} and Hughes, {Katherine C.} and Xiang Gao and Schwarzschild, {Michael A.} and Hannan, {Marian T.} and Rebecca Betensky and Alberto Ascherio",
year = "2018",
month = "5",
day = "8",
doi = "10.1212/WNL.0000000000005473",
language = "English (US)",
volume = "90",
pages = "e1646--e1653",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "19",

}

TY - JOUR

T1 - Integration of risk factors for Parkinson disease in 2 large longitudinal cohorts

AU - Kim, Iris Y.

AU - O'Reilly, Éilis J.

AU - Hughes, Katherine C.

AU - Gao, Xiang

AU - Schwarzschild, Michael A.

AU - Hannan, Marian T.

AU - Betensky, Rebecca

AU - Ascherio, Alberto

PY - 2018/5/8

Y1 - 2018/5/8

N2 - OBJECTIVE: To prospectively examine how selected lifestyle factors and family history of Parkinson disease (PD) combine to determine overall PD risk. METHODS: We derived risk scores among 69,968 women in the Nurses' Health Study (NHS) (1984-2012) and 45,830 men in the Health Professionals Follow-up Study (HPFS) (1986-2012). Risk scores were computed for each individual based on the following factors previously associated with PD risk: total caffeine intake, smoking, physical activity, and family history of PD for the NHS, and additionally total flavonoid intake and dietary urate index for the HPFS. Hazard ratios were estimated using Cox proportional hazards models. In addition, we performed tests of interactions on both the multiplicative and additive scale between pairs of risk factors. RESULTS: We documented 1,117 incident PD cases during follow-up. The adjusted hazard ratios comparing individuals in the highest category of the reduced risk score to those in the lowest category were 0.33 (95% confidence interval: 0.21, 0.49; ptrend < 0.0001) in the NHS and 0.18 (95% confidence interval: 0.10, 0.32; ptrend < 0.0001) in the HPFS. Results were similar when applying the risk scores computed by summing the predictors weighted by the log of their individual effect sizes on PD risk in these cohorts. Additive interaction was present between no family history of PD and caffeine in men and between caffeine and physical activity in women. CONCLUSIONS: Our results suggest that known protective factors for PD tend to have additive or superadditive effects, so that PD risk is very low in individuals with multiple protective risk factors.

AB - OBJECTIVE: To prospectively examine how selected lifestyle factors and family history of Parkinson disease (PD) combine to determine overall PD risk. METHODS: We derived risk scores among 69,968 women in the Nurses' Health Study (NHS) (1984-2012) and 45,830 men in the Health Professionals Follow-up Study (HPFS) (1986-2012). Risk scores were computed for each individual based on the following factors previously associated with PD risk: total caffeine intake, smoking, physical activity, and family history of PD for the NHS, and additionally total flavonoid intake and dietary urate index for the HPFS. Hazard ratios were estimated using Cox proportional hazards models. In addition, we performed tests of interactions on both the multiplicative and additive scale between pairs of risk factors. RESULTS: We documented 1,117 incident PD cases during follow-up. The adjusted hazard ratios comparing individuals in the highest category of the reduced risk score to those in the lowest category were 0.33 (95% confidence interval: 0.21, 0.49; ptrend < 0.0001) in the NHS and 0.18 (95% confidence interval: 0.10, 0.32; ptrend < 0.0001) in the HPFS. Results were similar when applying the risk scores computed by summing the predictors weighted by the log of their individual effect sizes on PD risk in these cohorts. Additive interaction was present between no family history of PD and caffeine in men and between caffeine and physical activity in women. CONCLUSIONS: Our results suggest that known protective factors for PD tend to have additive or superadditive effects, so that PD risk is very low in individuals with multiple protective risk factors.

UR - http://www.scopus.com/inward/record.url?scp=85053206375&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85053206375&partnerID=8YFLogxK

U2 - 10.1212/WNL.0000000000005473

DO - 10.1212/WNL.0000000000005473

M3 - Article

C2 - 29643081

AN - SCOPUS:85053206375

VL - 90

SP - e1646-e1653

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 19

ER -