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Constipation preceding Parkinson's disease: a systematic review and meta-analysis

Adams-Carr, KL; Bestwick, JP; Shribman, S; Lees, A; Schrag, A; Noyce, AJ; (2016) Constipation preceding Parkinson's disease: a systematic review and meta-analysis. J Neurol Neurosurg Psychiatry , 87 (7) pp. 710-716. 10.1136/jnnp-2015-311680. Green open access

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Abstract

OBJECTIVE: To systematically review published literature to estimate the magnitude of association between premorbid constipation and later diagnosis of Parkinson's disease. BACKGROUND: Constipation is a recognised non-motor feature of Parkinson's and has been reported to predate diagnosis in a number of observational studies. METHODS: A systematic review and meta-analysis was carried out following the Meta-analysis Of Observational Studies in Epidemiology (MOOSE) criteria. A literature search was undertaken in December 2014 using PubMed and the search terms 'Parkinson's disease' and 'constipation'. Articles were screened for suitability and reviewed against inclusion and exclusion criteria. Studies were included if they assessed constipation by means of a structured questionnaire or if constipation/drugs used to treat constipation were coded in patient medical records. Data were extracted using a standardised template and effect size estimates combined using a fixed-effects model. Heterogeneity was explored with the I(2) statistic. RESULTS: 9 studies were included in the meta-analysis, with a combined sample size of 741 593 participants. Those with constipation had a pooled OR of 2.27 (95% CI 2.09 to 2.46) for developing subsequent Parkinson's disease compared with those without constipation. Weak evidence for heterogeneity was found (I(2)=18.9%, p=0.282). Restricting analysis to studies assessing constipation more than 10 years prior to Parkinson's disease gave a pooled OR of 2.13 (95% CI 1.78 to 2.56; I(2)=0.0%). CONCLUSIONS: This systematic review and meta-analysis demonstrates that people with constipation are at a higher risk of developing Parkinson's disease compared with those without and that constipation can predate Parkinson's diagnosis by over a decade.

Type: Article
Title: Constipation preceding Parkinson's disease: a systematic review and meta-analysis
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1136/jnnp-2015-311680
Publisher version: http://dx.doi.org/10.1136/jnnp-2015-311680
Additional information: Copyright the author(s) 2015. Produced by BMJ Publishing Group Ltd under licence in the Journal of Neurology, Neurosurgery and Psychiatry.
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > UCL Queen Square Institute of Neurology > Clinical and Movement Neurosciences
URI: https://discovery.ucl.ac.uk/id/eprint/1480827
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