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Early constipation predicts faster dementia onset in Parkinson's disease

Lookup NU author(s): Dr Rachael LawsonORCiD



This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Constipation is a common but not a universal feature in early PD, suggesting that gut involvement is heterogeneous and may be part of a distinct PD subtype with prognostic implications. We analysed data from the Parkinson’s Incidence Cohorts Collaboration, composed of incident community-based cohorts of PD patients assessed longitudinally over 8 years. Constipation was assessed with the MDS-UPDRS constipation item or a comparable categorical scale. Primary PD outcomes of interest were dementia, postural instability and death. PD patients were stratified according to constipation severity at diagnosis: none (n=313, 67.3%), minor (n=97, 20.9%) and major (n=55, 11.8%). Clinical progression to all 3 outcomes was more rapid in those with more severe constipation at baseline (Kaplan Meier survival analysis). Cox regression analysis adjusting for relevant confounders confirmed a significant relationship between constipation severity and dementia, but not postural instability or death. Early constipation may predict an accelerated progression of neurodegenerative pathology.

Publication metadata

Author(s): Camacho M, Macleod AD, Maple-Grødem J, Evans JR, Breen DP, Cummins G, Wijeyekoon RS, Greenlan J, Alves G, Tysnes O, Lawson RA, Barker RA, Williams-Gray CH

Publication type: Article

Publication status: Published

Journal: npj Parkinson's Disease

Year: 2021

Volume: 7

Online publication date: 26/05/2021

Acceptance date: 26/02/2021

Date deposited: 17/03/2021

ISSN (electronic): 2373-8057

Publisher: Nature Research


DOI: 10.1038/s41531-021-00191-w


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Funder referenceFunder name
Parkinson’s UK