The association between lifestyle factors and Parkinson's disease progression and mortality.
Level 3 - non-randomized controlled study
Prospective cohort study with longitudinal follow-up
PubMed 30653734 · doi:10.1002/mds.27577
What was done
Researchers investigated associations between lifelong lifestyle exposures (coffee, tea, alcohol, smoking, physical activity) and Parkinson's disease (PD) progression and mortality in a prospective community-based cohort of 360 patients. All 360 patients were passively followed for mortality (2001–2016); 244 completed active follow-up (mean 5.3 ± 2.1 years, 2007–2014) with repeated motor (Hoehn & Yahr stage) and cognitive (Mini-Mental State Examination) assessments by movement disorder specialists. Analyses utilized Cox proportional hazards models with inverse probability weighting to adjust for censoring.
What was found
Coffee intake was associated with reduced risk of progressing to Hoehn & Yahr stage 3 (hazard ratio [HR] 0.52, 95% CI 0.28–1.01), cognitive decline (HR 0.23, 95% CI 0.11–0.48), and mortality (HR 0.47, 95% CI 0.32–0.69). Compared to moderate drinkers, never drinking liquor (HR 3.48, 95% CI 1.90–6.38) and heavy drinking (HR 2.16, 95% CI 1.03–4.54) were associated with increased risk of Hoehn & Yahr stage 3. History of competitive sports was protective against cognitive decline (HR 0.46, 95% CI 0.22–0.96) and Hoehn & Yahr stage 3 (HR 0.42, 95% CI 0.23–0.79), as was physical activity measured in metabolic-equivalent hours. Current smoking was associated with faster cognitive decline (HR 3.20, 95% CI 1.02–10.01). Caffeinated tea was reported as protective for at least one outcome, but numerical values were not stated in the abstract.
Why it matters
This study provides longitudinal evidence that modifiable lifestyle habits—particularly physical exercise, caffeine consumption, and avoiding smoking or heavy drinking—are linked to motor progression, cognitive preservation, and survival after a Parkinson's diagnosis.
Limits
The observational design cannot establish causality and is subject to reverse causation, where advancing symptoms reduce physical activity or alter consumption patterns. Lifelong lifestyle exposure was assessed retrospectively, introducing recall bias. Active clinical follow-up was limited to a subgroup of 244 participants, and specific risk metrics for tea were omitted from the abstract.
Cited by
- contradicts Parkinson's disease patients who smoked tobacco have demonstrated better outcomes because Parkinson's disease is primarily an acetylcholine deficiency state.