Constipation Predicts Cognitive Decline in Parkinson's Disease: Results from the COPPADIS Cohort at 2-Year Follow-up and Comparison with a Control Group
Por:
Santos García D, García Roca L, de Deus Fonticoba T, Cores Bartolomé C, Naya Ríos L, Canfield H, Paz González JM, Martínez Miró C, Jesús S, Aguilar M, Pastor P, Planellas L, Cosgaya M, García Caldentey J, Caballol N, Legarda I, Hernández Vara J, Cabo I, López Manzanares L, González Aramburu I, Ávila Rivera MA, Gómez Mayordomo V, Nogueira V, Puente V, Dotor García-Soto J, Borrué C, Solano Vila B, Álvarez Sauco M, Vela L, Escalante S, Cubo E, Carrillo Padilla F, Martínez Castrillo JC, Sánchez Alonso P, Alonso Losada MG, López Ariztegui N, Gastón I, Kulisevsky J, Blázquez Estrada M, Seijo M, Rúiz Martínez J, Valero C, Kurtis M, de Fábregues O, González Ardura J, Alonso Redondo R, Ordás C, López Díaz L LM, McAfee D, Martinez-Martin P, Mir P and COPPADIS Study Group
Publicada:
1 ene 2022
Ahead of Print:
30 sep 2021
Resumen:
Background: Constipation has been linked to cognitive impairment development in Parkinson's disease (PD).
Objective: Our aim was to analyze cognitive changes observed in PD patients and controls from a Spanish cohort with regards to the presence or not of constipation.
Methods: PD patients and controls recruited from 35 centers of Spain from the COPPADIS cohort from January 2016 to November 2017 were followed-up during 2 years. The change in cognitive status from baseline (V0) to 2-year follow-up was assessed with the PD-CRS (Parkinson's Disease Cognitive Rating Scale). Subjects with a score >= 1 on item 21 of the NMSS (Non-Motor Symptoms Scale) at baseline (V0) were considered as "with constipation". Regression analyses were applied for determining the contribution of constipation in cognitive changes.
Results: At V0, 39.7% (198/499) of PD patients presented constipation compared to 11.4% of controls (14/123) (p < 0.0001). No change was observed in cognitive status (PD-CRS total score) neither in controls without constipation (from 100.24 +/- 13.72 to 100.27 +/- 13.68; p = 0.971) and with constipation (from 94.71 +/- 10.96 to 93.93 +/- 13.03; p = 0.615). The PD-CRS total score decreased significantly in PD patients with constipation (from 89.14 +/- 15.36 to 85.97 +/- 18.09; p <0.0001; Coehn's effect = -0.35) compared to patients without constipation (from 93.92 +/- 15.58 to 93.14 +/- 17.52; p = 0.250) (p = 0.018). In PD patients, to suffer from constipation at VO was associated with a decrease in the PD-CRS total score from V0 to V2 (beta=-0.1; 95%CI, -4.36 - -0.27; p = 0.026) and having cognitive impairment at V2 (OR =1.79; 95%CI, 1.01 - 3.17; p = 0.045).
Conclusion: Constipation is associated with cognitive decline in PD patients but not in controls.
Filiaciones:
Santos García D:
CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
García Roca L:
CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
de Deus Fonticoba T:
CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain
Cores Bartolomé C:
CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
Naya Ríos L:
CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain
Canfield H:
CHUF, Complejo Hospitalario Universitario de Ferrol, A Coruña, Spain
Paz González JM:
CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
Martínez Miró C:
CHUAC, Complejo Hospitalario Universitario de A Coruña, A Coruña, Spain
Jesús S:
Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Spain
Aguilar M:
Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
Pastor P:
Hospital Universitari Mutua de Terrassa, Terrassa, Barcelona, Spain
Planellas L:
Clínica del Pilar, Barcelona, Spain
Cosgaya M:
Hospital Clinic de Barcelona, Barcelona, Spain
García Caldentey J:
Centro Neurológico Oms 42, Palma de Mallorca, Spain
Caballol N:
Consorci Sanitari Integral, Hospital Moisés Broggi, Sant Joan Despí, Barcelona, Spain
Legarda I:
Hospital Universitario Son Espases, Palma de Mallorca, Spain
Hernández Vara J:
CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Spain
Hospital Universitario Vall d'Hebron, Barcelona, Spain
Cabo I:
Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
López Manzanares L:
Hospital Universitario La Princesa, Madrid, Spain
González Aramburu I:
CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Spain
Hospital Universitario Marqués de Valdecilla, Santander, Spain
Ávila Rivera MA:
Consorci Sanitari Integral, Hospital General de L'Hospitalet, L'Hospitalet de Llobregat, Barcelona, Spain
Gómez Mayordomo V:
Hospital Universitario Clínico San Carlos, Madrid, Spain
Nogueira V:
Hospital Da Costa, Burela, Lugo, Spain
Puente V:
Hospital del Mar, Barcelona, Spain
Dotor García-Soto J:
Hospital Universitario Virgen Macarena, Sevilla, Spain
Borrué C:
Hospital Infanta Sofía, Madrid, Spain
Solano Vila B:
Institut d'Assistència Sanitària (IAS) - Institut Català de la Salut, Girona, Spain
:
Hospital General Universitario de Elche, Elche, Spain
Vela L:
Fundación Hospital de Alcorcón, Madrid, Spain
Escalante S:
Hospital de Tortosa Verge de la Cinta (HTVC), Tortosa, Tarragona, Spain
Cubo E:
Complejo Asistencial Universitario de Burgos, Burgos, Spain
Carrillo Padilla F:
Hospital Universitario de Canarias, San Cristóbal de la Laguna, Santa Cruz de Tenerife, Spain
Martínez Castrillo JC:
Hospital Universitario Ramón y Cajal, IRYCIS, Madrid, Spain
Sánchez Alonso P:
Hospital Universitario Puerta de Hierro, Madrid, Spain
Alonso Losada MG:
Hospital Álvaro Cunqueiro, Complejo Hospitalario Universitario de Vigo (CHUVI), Vigo, Spain
López Ariztegui N:
Complejo Hospitalario de Toledo, Toledo, Spain
Gastón I:
Complejo Hospitalario de Navarra, Pamplona, Spain
Kulisevsky J:
CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Spain
Hospital de Sant Pau, Barcelona, Spain
Blázquez Estrada M:
Hospital Universitario Central de Asturias, Oviedo, Spain
Seijo M:
Complejo Hospitalario Universitario de Pontevedra (CHOP), Pontevedra, Spain
Rúiz Martínez J:
Hospital Universitario Donostia, San Sebastián, Spain
:
Hospital Arnau de Vilanova, Valencia, Spain
Kurtis M:
Hospital Ruber Internacional, Madrid, Spain
de Fábregues O:
Hospital Universitario Vall d'Hebron, Barcelona, Spain
González Ardura J:
Hospital de Cabueñes, Gijón, Spain
Alonso Redondo R:
Universitario Lucus Augusti (HULA), Lugo, Spain
Ordás C:
Hospital Rey Juan Carlos, Madrid, Spain, Madrid, Spain
López Díaz L LM:
Complejo Hospitalario Universitario de Orense (CHUO), Orense, Spain
McAfee D:
University of Maryland School of Medicine, Baltimore, MD, USA
Martinez-Martin P:
CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Spain
Mir P:
CIBERNED (Centro de Investigación Biomédica en Red Enfermedades Neurodegenerativas), Spain
Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
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