Weisskopf Marc G, Chen Honglei, Schwarzschild Michael A, Kawachi Ichiro, Ascherio Alberto
Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA.
Mov Disord. 2003 Jun;18(6):646-51. doi: 10.1002/mds.10425.
Anxiety disorders are common in Parkinson's disease (PD). However, the risk of PD among people with anxiety has not been examined in a prospective cohort study. We examined this relation prospectively within the Health Professionals Follow-Up Study, a cohort of US male health professionals. In 1988, anxiety was assessed using the Crown-Crisp phobic anxiety index in 35,815 men without PD, stroke, or cancer at baseline. There were 189 incident cases of PD during 12 years of follow-up. After adjusting for age, smoking, and caffeine intake, the relative risk of PD among men with the highest level of anxiety (Crown-Crisp index scores of 4 and above) was 1.5 (95% CI = 1.0-2.1; P-trend = 0.01) compared to men with the lowest level of anxiety. This positive association persisted after excluding cases of PD with onset in the first 2 years of follow-up. Use of anxiolytic medication was also associated with an elevated risk of PD (RR= 1.6; 95% CI = 0.9-3.1), but adjusting for this potential confounder did not materially affect the association between anxiety and risk of PD. Our results suggest that anxiety is a risk factor for PD. Whether this association is causal or the result of shared underlying biology remains a question.
焦虑症在帕金森病（PD）中很常见。然而，焦虑症患者患帕金森病的风险尚未在前瞻性队列研究中得到检验。我们在健康专业人员随访研究中对这种关系进行了前瞻性研究，该研究是一个由美国男性健康专业人员组成的队列。1988年，在35815名基线时无帕金森病、中风或癌症的男性中，使用皇冠-克里斯普恐惧症焦虑指数评估焦虑情况。在12年的随访期间，有189例帕金森病新发病例。在调整年龄、吸烟和咖啡因摄入量后，焦虑程度最高（皇冠-克里斯普指数得分4及以上）的男性患帕金森病的相对风险为1.5（95%可信区间=1.0-2.1；P趋势=0.01），而焦虑程度最低的男性。在排除随访前两年内发病的帕金森病病例后，这种正相关关系仍然存在。使用抗焦虑药物也与患帕金森病的风险升高有关（RR=1.6；95%可信区间=0.9-3.1），但对这一潜在混杂因素进行调整并未实质性影响焦虑与帕金森病风险之间的关联。我们的结果表明，焦虑是帕金森病的一个风险因素。这种关联是因果关系还是共同潜在生物学因素的结果仍然是一个问题。
