Occupation and Parkinson disease in the Women's Health Initiative Observational Study

Burstyn, Igor; LaCroix, Andrea Z.; Litvan, Irene; Wallace, Robert B.; Checkoway, Harvey

doi:10.1002/ajim.23022

Cited by 11 publications

(9 citation statements)

References 35 publications

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“…CC-BY-ND 4.0 International license It is made available under a is the author/funder, who has granted medRxiv a license to display the preprint in perpetuity. (which was not certified by peer review) already been diagnosed with PD and thus have a declining health-related quality of life 7,[17][18][19][35][36][37][38][39][40][41][42][43] .…”

Section: Discussionmentioning

confidence: 99%

“…This study sets the stage for acknowledging the role WSHFs have in the severity of PD. While there have been studies looking at PD risk and some WSHFs, they overlook the growing population of women who have already been diagnosed with PD and thus have a declining health-related quality of life 7,[17][18][19][35][36][37][38][39][40][41][42][43] .…”

Section: Discussionmentioning

confidence: 99%

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Association of Women-Specific Health Factors in the Severity of Parkinson’s Disease

Rao

Li²,

Lapin³

et al. 2022

Preprint

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Background Parkinson′s disease (PD) is an age-related neurological disorder known for the observational differences in its risk, progression, and severity between men and women. While estrogen has been considered to be a protective factor in the development of PD, there is little known about the role that fluctuations in hormones and immune responses from sex-specific health experiences have in the disease′s development and severity. Objective We sought to identify women-specific health experiences associated with PD severity by developing and distributing a women-specific questionnaire across the United States. Design We created a questionnaire that addresses women′s specific experiences and their PD clinical history and deployed it through The Parkinson′s Foundation: PD Generations. To determine the association between women-specific health factors and PD severity, we constructed multivariable logistic regression models based on the MDS-UPDRS scale and the participants′ questionnaire responses, genetics, and clinical data. Results For our initial launch in November 2021, we had 304 complete responses from PD GENEration. Univariate and multivariate logistic modeling found significant associations between major depressive disorder, perinatal depression, natural childbirth, LRRK2 genotype, B12 deficiency, total hysterectomy and increased PD severity. Conclusions This study is the first nationally available questionnaire for women′s health and PD. It shifts the paradigm in understanding PD etiology and acknowledging how sex-specific experiences may contribute to PD severity. In addition, the work in this study sets the foundation for future research to investigate the reasons behind the sex differences in PD.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Association of Women-Specific Health Factors in the Severity of Parkinson’s Disease

Rao

Li²,

Lapin³

et al. 2022

Preprint

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“…Incident PD was defined at each available year of follow‐up, including self‐reported PD from the WHI medical update form, Medicare (MEDPAR, outpatient and carrier) codes that reflect the first occurrence of PD primary or secondary diagnosis using ICD‐9‐CM and International Classification of Diseases (10th Revision [ICD‐10]) diagnostic codes (as appropriate), use of medications consistent with PD diagnosis (forms 44 and 153) and/or deaths attributed to PD (Tables S1‐S2) 36 . The level of agreement between PD definitions with and without ICD‐9‐CM/ICD‐10 diagnostic codes was estimated amongst eligible subjects (κ = 0.44, 95% CI: 0.42, 0.47).…”

Section: Methodsmentioning

confidence: 99%

“…Incident PD was defined at each available year of followup, including self-reported PD from the WHI medical update form, Medicare (MEDPAR, outpatient and carrier) codes that reflect the first occurrence of PD primary or secondary diagnosis using ICD-9-CM and International Classification of Diseases (10th Revision [ICD-10]) diagnostic codes (as appropriate), use of medications consistent with PD diagnosis (forms 44 and 153) and/or deaths attributed to PD (Tables S1-S2). 36 The level of agreement between PD definitions with and without ICD-9-CM/ICD-10 diagnostic codes was estimated amongst eligible subjects (j = 0.44, 95% CI: 0.42, 0.47). Time-toevent, whether PD onset, loss to follow-up or death, were calculated from the baseline questionnaire until December 31, 2018, whichever came first, whilst ensuring the exclusion of PD cases and follow-up time between baseline and 3 years of follow-up to account for immortal time bias.…”

Section: Parkinson's Diseasementioning

confidence: 99%

Psychotropic medication use and Parkinson's disease risk amongst older women

Beydoun

Saquib

Wallace

et al. 2022

Ann Clin Transl Neurol

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Objective: To examine associations of antidepressant, anxiolytic and hypnotic use amongst older women (≥65 years) with incident Parkinson's Disease (PD), using data from Women's Health Initiative linked to Medicare claims. Methods: PD was defined using self-report, first diagnosis, medications and/or death certificates and psychotropic medications were ascertained at baseline and 3-year follow-up. Cox regression models were constructed to calculate adjusted hazard ratios (aHR) with 95% confidence intervals (CI), controlling for sociodemographic, lifestyle and health characteristics, overall and amongst women diagnosed with depression, anxiety and/or sleep disorders (DASD). Results: A total of 53,996 WHI participants (1,756 PD cases)-including 27,631 women diagnosed with DASD (1,137 PD cases)-were followed up for ~14 years. Use of hypnotics was not significantly associated with PD risk (aHR = 0.98, 95% CI: 0.82, 1.16), whereas PD risk was increased amongst users of antidepressants (aHR = 1.75, 95% CI: 1.56, 1.96) and anxiolytics (aHR = 1.48, 95% CI: 1.25, 1.73). Compared to non-users of psychotropic medications, those who used 1 type had ~50% higher PD risk, whereas those who used ≥2 types had ~150% higher PD risk. Women who experienced transitions in psychotropic medication use ('use to non-use' or 'non-use to use') between baseline and 3-year follow-up had higher PD risk than those who did not. We obtained similar results with propensity scoring and amongst DASD-diagnosed women. Interpretation: The use of antidepressants, anxiolytics or multiple psychotropic medication types and transitions in psychotropic medication use was associated with increased PD risk, whereas the use of hypnotics was not associated with PD risk amongst older women.

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“…Incident PD was defined at each available year of followup, and included self-reported PD diagnosis (''yes'' when asked ''Has a doctor ever told you that you have Parkinson disease''), deaths attributed to PD and/or use of medications consistent with PD diagnosis (Medication forms 44 and 153, Therapeutic Classes of 730000-734030), as previously reported by another WHI-based study. 40 Time-to-event, whether incident PD, death or loss to follow-up, was calculated from the baseline questionnaire until March 1, 2019.…”

Section: Parkinson Diseasementioning

confidence: 99%

Association of sleep disturbance with Parkinson disease: evidence from the Women's Health Initiative

et al. 2022

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Objective: To examine the association of sleep disturbance with Parkinson disease (PD) during 10þ years of follow-up among postmenopausal women, 50 to 79 years of age at baseline. Methods: Longitudinal data on 130,502 study-eligible women (mean AE standard deviation baseline age ¼ 63.16 AE 7.20 y) from the Women's Health Initiative Clinical Trials and Women's Health Initiative Observational Study were analyzed. The cohort was followed for 15.88 AE 6.50 years, yielding 2,829 (2.17%) PD cases. Sleep disturbance (habitual sleep duration, insomnia symptoms, obstructive sleep apnea risk factors, sleep aids among those with WHI Insomnia Rating Scale scores (WHIIRS) > 9) was measured at baseline and one follow-up time by September 12, 2005. Cox proportional hazards models evaluated relationships controlling for sociodemographic, lifestyle, and health characteristics.Results: PD was significantly associated with long sleep duration (!9 h) versus a benchmark of 7 to 8 hours (hazard ratio [HR] ¼ 1.296, 95% confidence interval [CI]: 1.153-1.456), WHIIRS (>9 vs 9) (HR ¼ 1.114, 95% CI:1.023-1.214), and use of sleep aids (yes vs no) (HR ¼ 1.332, 95% CI:1.153-1.539) among those with WHIIRS > 9. Compared with 7 to 8 hours, short (<7 h) sleep duration was unrelated to PD. Finally, the presence of obstructive sleep apnea risk factors was not associated with PD.Conclusions: Among postmenopausal women, sleep disturbance was associated with approximately 10% to 30% increased PD risk after $16 years follow-up. Prospective cohort studies with objective exposures and adjudicated outcomes that include men and women of diverse backgrounds are required to confirm and extend these findings.

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Occupation and Parkinson disease in the Women's Health Initiative Observational Study

Cited by 11 publications

References 35 publications

Association of Women-Specific Health Factors in the Severity of Parkinson’s Disease

Association of Women-Specific Health Factors in the Severity of Parkinson’s Disease

Psychotropic medication use and Parkinson's disease risk amongst older women

Association of sleep disturbance with Parkinson disease: evidence from the Women's Health Initiative

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