title: Increased Risk of Parkinson's Disease in Patients With Obstructive Sleep Apnea: A Population-Based, Propensity Score-Matched, Longitudinal Follow-Up Study.
abstract: Obstructive sleep apnea (OSA), characterized by repetitive episodes of apnea/hypopnea and hypoxia, is associated with systemic inflammation and induces metabolic, endocrine, and cardiovascular diseases. Inflammation might have an impact on neurodegenerative diseases. This study investigates the possible association between OSA and Parkinson's disease (PD). Random samples out of 1 million individuals were collected from Taiwan's National Health Insurance database. A total of 16,730 patients with newly diagnosed OSA from 2002 to 2008 were recruited and compared with a cohort of 16,730 patients without OSA matched for age, gender, and comorbidities using propensity scoring. All patients were tracked until a diagnosis of PD, death, or the end of 2011.During the mean 5.6-year follow-up period, the incidence rates of PD were 2.30 per 1000 person-years in the OSA cohort and 1.71per 1000 person-years in the comparison group. The incidence rate ratio (IRR) for PD was greater in older patients (≧ 65 years) and male patients with OSA than the controls, respective IRRs being 1.34 and 1.47. After adjustment for the comorbidities, patients with OSA were 1.37 times more likely to have PD than patients without (95% CI = 1.12-1.68, P < 0.05). Subgroup analysis showed that older patients and patients with coronary artery disease, stroke, or chronic kidney disease had a higher risk for PD than their counter parts. Log-rank analysis revealed that patients with OSA had significantly higher cumulative incidence rates of PD than the comparison group (P = 0.0048). Patients with OSA are at an increased risk for subsequent PD, especially elderly male patients.
authors.affiliation: From the Division of Endocrinology and Metabolism, Department of Internal Medicine, Chi Mei Medical Center (N-CY, K-JT); Department of Neurology (C-MY); Department of Medical Research, Chi Mei Medical Center (J-JW); Department of Healthcare Administration and Medical Informatics, Kaohsiung Medical University, Kaohsiung, Taiwan (S-FW); and Department of Senior Citizen Service Management, Chia Nan University of Pharmacy and Science, Tainan, Taiwan (K-JT).
authors.forename: Nai-Cheng
authors.initials: NC
authors.lastname: Yeh
authors.forename: Kai-Jen
authors.initials: KJ
authors.lastname: Tien
authors.forename: Chun-Ming
authors.initials: CM
authors.lastname: Yang
authors.forename: Jhi-Joung
authors.initials: JJ
authors.lastname: Wang
authors.forename: Shih-Feng
authors.initials: SF
authors.lastname: Weng
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000150:complications* / Q000453:epidemiology; D057216:Propensity Score; D018570:Risk Assessment; D020181:Sleep Apnea, Obstructive / Q000150:complications* / Q000453:epidemiology; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult