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Constipation preceding stroke, dementia and Parkinson’s disease in middle-aged and older adults: a population-based cohort study

医学 便秘 痴呆 疾病 队列研究 儿科 队列 梅德林 内科学 回顾性队列研究 老年人 物理疗法 风险因素 前瞻性队列研究 中枢神经系统疾病 阿尔茨海默病 流行病学
作者
Qingping Yun,Shiyu Wang,Bingyu Li,Zhirong Yang,Chang Wei,Jinqiu Yuan,Jun Hu,Ye Li,Zu‐Yao Yang,Feng Sha,Jin-Ling Tang
出处
期刊:Age and Ageing [Oxford University Press]
卷期号:54 (9) 被引量:3
标识
DOI:10.1093/ageing/afaf257
摘要

BACKGROUND: Previous research indicates that constipation may be an early symptom of Parkinson's disease (PD). However, it remains uncertain whether constipation is a unique symptom prior to PD or to other major neurological disorders as well. This study aimed to explore the association between premorbid constipation and three major neurological disorders: stroke, dementia and PD. METHODS: We conducted a retrospective cohort study using data from UK Biobank. Constipation was defined based on diagnosed cases in electronic health records, self-reported instances or regular laxative use. The primary outcome was defined as the first onset of any of three neurological disorders: stroke, dementia and PD. Cox regression was used to adjust for socio-demographic characteristics, lifestyle factors, medical conditions and regular medication use. RESULTS: Out of 462,327 eligible participants, those with constipation were associated with higher incidence of three outcome diseases (1415/20,263 [7.0%]) than those without (18,848/442,064 [4.3%]), with adjusted hazard ratio (HR) being 1.35 [1.27-1.42]. Specifically, those with constipation had a 20%, 50% and 56% higher risk of stroke, dementia and PD, respectively. Both self-reported and diagnosed constipation were associated with a higher risk of these conditions, with HR being 1.31 (1.23-1.40) and 1.44 (1.30-1.59), respectively. Interestingly, the association between constipation and neurological disorders was stronger within the first 2 years from baseline. DISCUSSION: These findings support the biological link between constipation and neurological disorders. Given its potential role as a prodromal symptom for these diseases, both diagnosed and self-reported constipation should be considered in risk prediction models.
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