title: Parkinson's disease research in a prospective cohort in China.
abstract: BACKGROUND
  China has the largest population of Parkinson's disease (PD) patients; however few etiological studies of PD have been conducted in China.
  
  
  METHODS
  The Shanghai Women's Health Study recruited 74,941 women in urban Shanghai, aged 40 to 70, from 1996 to 2000. Self-reported PD cases were invited for a neurological examination and diagnoses were made by a movement disorder specialist.
  
  
  RESULTS
  This cohort had very few smokers (2.7%), alcohol drinkers (2.3%), and post-menopausal hormone users (4.3%); however, tea drinking (29.9%) and exposure to tobacco smoke from husbands (61.8%) were common. A total of 301 participants reported PD diagnosis during the follow-up. The diagnosis was confirmed in 76 (57%) of the 133 clinically examined patients. An additional 19 (53%) PD cases were identified out of 36 participants who self-confirmed the diagnosis and provided a history on PD symptoms and treatments. As expected, increasing age was strongly associated with PD risk. Further, PD risk appears to be inversely associated with exposures to second-hand tobacco smoke from husbands and tea drinking, and positively with education, although none of these reached statistical significance. The age-adjusted odds ratio (OR) was 0.7 (95% confidence interval: 0.4-1.1) for participants whose husbands were current smokers at baseline and 0.8 (0.5-1.3) for ever tea-drinkers. Compared with primary education or lower, the age-adjusted OR was 1.3 (0.7-2.4) for middle school and 1.6 (1.0-2.7) for high school or above.
  
  
  CONCLUSIONS
  PD research in this unique cohort is feasible and, with extended follow-up, will allow for prospective PD etiological research in China.
authors: Epidemiology Branch of the National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA. Electronic address: chenh2@niehs.nih.gov.
authors: Honglei
authors: H
authors: Chen
authors: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Ding
authors: D
authors: Ding
authors: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Jian
authors: J
authors: Wang
authors: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Qianhua
authors: Q
authors: Zhao
authors: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Haijiao
authors: H
authors: Meng
authors: The Shanghai Cancer Institute, China.
authors: Honglan
authors: H
authors: Li
authors: The Shanghai Cancer Institute, China.
authors: Yu-Tang
authors: YT
authors: Gao
authors: Vanderbilt University, Nashville, TN, USA.
authors: Xiao-Ou
authors: XO
authors: Shu
authors: Disease Research Education and Clinical Center, San Francisco Veteran's Affairs Medical Center & Department of Neurology, University of California - San Francisco, San Francisco, CA, USA.
authors: Caroline M
authors: CM
authors: Tanner
authors: Department of Neurology, Huashan Hospital, Fudan University, Shanghai, China.
authors: Zhen
authors: Z
authors: Hong
authors: Vanderbilt University, Nashville, TN, USA.
authors: Gong
authors: G
authors: Yang
mesh_terms: D000328:Adult; D000368:Aged; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D010300:Parkinson Disease / Q000453:epidemiology*; D012307:Risk Factors; D011795:Surveys and Questionnaires
keywords: Cohort studies; Parkinson's disease/Parkinsonism; Risk factors in epidemiology