Environmental, life-style, and physical precursors of clinical Parkinson's disease: recent findings from the Honolulu-Asia Aging Study.
BACKGROUND
Increased westernization with Japanese migration to the U. S. in the early 20(th) century is thought to have altered the risk of cardiovascular disease. Whether similar effects include changes in the risk of Parkinson's disease (PD) is not clear. This report describes the relations between environmental, life-style, and physical attributes and the incidence of PD that have been observed in the Honolulu-Asia Aging Study.


METHODS
Beginning in 1965, environmental, life-style, and physical attributes were recorded at selected examinations in a cohort of 8,006 Japanese-American men. Subjects were followed for clinical PD.


RESULTS
During 30 years of follow- up, PD was observed in 137 men. Overall incidence (7.1/10,000 person-years) was generally higher than in Asia and similar to rates observed in Europe and the U. S. Precursors of PD included constipation, adiposity, years worked on a sugar or pineapple plantation, years of exposure to pesticides, and exposure to sugar cane processing. Factors showing an inverse association with PD included coffee intake and cigarette smoking. Among dietary factors, carbohydrates increased the risk of PD while the intake of polyunsaturated fats appeared protective. Total caloric intake, saturated and monounsaturated fats, protein, niacin, riboflavin, beta-carotene, vitamins A, B, and C, dietary cholesterol, cobalamin, alpha-tocopherol, and pantothenic acid showed no clear relation with clinical PD.


CONCLUSIONS
Findings suggest that several environmental, life-style, and physical attributes appear to be precursors of PD. Whether patterns of precursors can be used to identify individuals at high risk of future PD or can broaden the scope of early interventions or recruitment into neuroprotective trials warrants further study.
Abbott
Robert D
RD
University of Virginia Health System, Department of Health Evaluation Sciences, 800717, Charlottesville, Virginia 22908-0717, USA. rda3e@virginia.edu
Ross
G Webster
GW
White
Lon R
LR
Sanderson
Wayne T
WT
Burchfiel
Cecil M
CM
Kashon
Michael
M
Sharp
Dan S
DS
Masaki
Kamal H
KH
Curb
J David
JD
Petrovitch
Helen
H
D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D001208:Asia / Q000453:epidemiology; D001823:Body Composition; D003069:Coffee; D003248:Constipation / Q000503:physiopathology; D004032:Diet; D004781:Environmental Exposure / Q000009:adverse effects; D006801:Humans; D015994:Incidence; D008019:Life Style; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology* / Q000209:etiology*; D010575:Pesticides / Q000009:adverse effects; D012307:Risk Factors; D012907:Smoking
D003069:Coffee; D010575:Pesticides