Department of Epidemiology, UCLA Fielding School of Public Health, Los Angeles, California, USA.
Department of Neurology, David Geffen School of Medicine, Los Angeles, California, USA.
Mov Disord. 2019 Jan;34(1):58-66. doi: 10.1002/mds.27577.
Lifestyle factors may contribute to the development of Parkinson's disease, but little is known about factors that influence progression. The objective of the current study was to examine whether caffeine or alcohol consumption, physical activity, or cigarette smoking is associated with progression and survival among PD patients.
We assessed lifelong coffee, tea, and alcohol consumption, smoking, and physical activity in a prospective community-based cohort (n = 360). All patients were passively followed for mortality (2001-2016); 244 were actively followed on average ± SD 5.3 ± 2.1 years (2007-2014). Movement disorder specialists repeatedly assessed motor function (Hoehn & Yahr) and cognition (Mini-Mental State Exam). We used Cox proportional hazards models and inverse probability weights to account for censoring.
Coffee, caffeinated tea, moderate alcohol consumption, and physical activity were protective against at least 1 outcome. Smoking and heavy alcohol consumption were associated with increased risks. Coffee was protective against time to Hoehn & Yahr stage 3 (hazard ratio, 0.52; 95% confidence interval, 0.28-1.01), cognitive decline (hazard ratio, 0.23; 95% confidence interval, 0.11, 0.48), and mortality (hazard ratio, 0.47; 95% confidence interval, 0.32-0.69). Relative to moderate drinkers, those who never drank liquor and those who drank more heavily were at an increased risk of Hoehn & Yahr 3 (hazard ratio, 3.48; 95% confidence interval, 1.90-6.38; and hazard ratio, 2.16; 95% confidence interval, 1.03, 4.54, respectively). A history of competitive sports was protective against cognitive decline (hazard ratio, 0.46; 95% confidence interval, 0.22-0.96) and Hoehn & Yahr 3 (hazard ratio, 0.42; 95% confidence interval, 0.23-0.79), as was physical activity measured by metabolic-equivalent hours. Current cigarette smoking was associated with faster cognitive decline (hazard ratio, 3.20; 95% confidence interval, 1.02-10.01).
This population-based study suggests that lifestyle factors influence PD progression and mortality. © 2019 International Parkinson and Movement Disorder Society.
生活方式因素可能导致帕金森病的发生，但对于影响疾病进展的因素知之甚少。本研究的目的是探究咖啡因或酒精摄入、体力活动或吸烟是否与帕金森病患者的进展和生存相关。
我们评估了前瞻性社区队列(n=360)中参与者终生的咖啡、茶和酒精摄入、吸烟和体力活动情况。所有患者均接受被动随访以记录死亡情况(2001-2016 年)；244 名患者接受平均(±SD)5.3±2.1 年的主动随访(2007-2014 年)。运动障碍专家反复评估运动功能(Hoehn&Yahr)和认知功能(简易精神状态检查)。我们使用 Cox 比例风险模型和逆概率权重来校正删失数据。
咖啡、含咖啡因的茶、适量饮酒和体力活动对至少一种结果具有保护作用。吸烟和大量饮酒与风险增加相关。咖啡可预防 Hoehn&Yahr 分期达到 3 期(风险比 0.52；95%置信区间 0.28-1.01)、认知功能下降(风险比 0.23；95%置信区间 0.11-0.48)和死亡(风险比 0.47；95%置信区间 0.32-0.69)。与适量饮酒者相比，从不饮酒者和大量饮酒者的 Hoehn&Yahr 分期 3 期风险增加(风险比 3.48；95%置信区间 1.90-6.38；风险比 2.16；95%置信区间 1.03-4.54)。竞技运动史可预防认知功能下降(风险比 0.46；95%置信区间 0.22-0.96)和 Hoehn&Yahr 分期 3 期(风险比 0.42；95%置信区间 0.23-0.79)，代谢当量小时数所反映的体力活动也具有保护作用。目前吸烟与认知功能下降加速相关(风险比 3.20；95%置信区间 1.02-10.01)。
本基于人群的研究表明，生活方式因素影响帕金森病的进展和死亡率。
