title: Bowel movement frequency in late-life and incidental Lewy bodies.
abstract: It is not known if constipation is associated with the preclinical phase of Parkinson's disease (PD), often characterized by the presence of incidental Lewy bodies (ILB). Such an association could provide evidence that constipation is an early symptom of PD. The purpose of this report is to examine the association between late-life bowel movement frequency and ILB. Bowel movement frequency was assessed from 1991 to 1993 in 245 men aged 71 to 93 years in the Honolulu-Asia Aging Study who later received postmortem examinations. All were without clinical PD and dementia. Brains were examined for ILB in the substantia nigra and locus ceruleus. Among the decedents, 30 men had ILB (12.2%). After age-adjustment, the percent of brains with ILB declined with increasing bowel movement frequency (P=0.013). For men with <1, 1, and >1 bowel movement/day, corresponding percents were 24.1, 13.5, and 6.5%. Findings persisted after additional adjustment for time to death, mid-life pack-years of smoking and coffee intake, physical activity, and cognitive function. Infrequent bowel movements are associated with ILB. Findings provide evidence that constipation can predate the extrapyramidal signs of PD. Constipation could be one of the earliest markers of the beginning of PD processes.
authors.affiliation: Division of Biostatistics and Epidemiology, University of Virginia School of Medicine, Charlottesville, Virginia 22908-0717, and Veterans Affairs Pacific Islands Health Care System, Honolulu, HI, USA. rda3e@virginia.edu
authors.forename: Robert D
authors.initials: RD
authors.lastname: Abbott
authors.forename: G Webster
authors.initials: GW
authors.lastname: Ross
authors.forename: Helen
authors.initials: H
authors.lastname: Petrovitch
authors.forename: Caroline M
authors.initials: CM
authors.lastname: Tanner
authors.forename: Daron G
authors.initials: DG
authors.lastname: Davis
authors.forename: Kamal H
authors.initials: KH
authors.lastname: Masaki
authors.forename: Lenore J
authors.initials: LJ
authors.lastname: Launer
authors.forename: J David
authors.initials: JD
authors.lastname: Curb
authors.forename: Lon R
authors.initials: LR
authors.lastname: White
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001213:Asian; D001921:Brain / Q000473:pathology*; D003248:Constipation / Q000453:epidemiology* / Q000473:pathology*; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016631:Lewy Bodies / Q000473:pathology*; D008297:Male; D011180:Postmortem Changes; D012189:Retrospective Studies