Caffeine, alcohol and exercise: Triumvirate against Parkinson’s disease
A trio of lifestyle factors—drinking caffeinated coffee or tea, swigging alcohol in moderate levels and engaging in physical activity—appears to protect against symptom progression in Parkinson’s disease (PD), according to a recent study.
“Lifestyle practices present modifiable factors that can improve health‐related quality of life and are known to influence the occurrence of many chronic diseases, including cardiovascular events and cancers, and our study suggests this may also extend to the progression of PD,” the authors said.
The study population included 244 PD patients (mean age at diagnosis, 66.9 years; 57 percent male), among whom 127 showed signs of progression over a mean follow-up of 5.3 years. Specifically, motor function worsened in 77 patients (32 percent; Hoen & Yahr [H&Y] stage ≥3), while cognitive function declined in 50 patients (21 percent; ≥4‐point decline on the Mini‐Mental State Exam [MMSE]).
In Cox proportional hazards models, coffee, caffeinated tea, moderate alcohol consumption and physical activity conferred benefits for motor and/or cognitive function. Conversely, smoking and heavy alcohol consumption proved to be detrimental. [Mov Disord 2019;34:58-66]
Ever coffee consumption reduced the risks of H&Y stage 3 progression (hazard ratio [HR], 0.52; 95 percent CI, 0.28–1.01), cognitive decline (HR, 0.23; 0.11–0.48) and mortality (HR, 0.47; 0.32–0.69). Caffeinated tea consumption also had a similar effect on mortality (HR, 0.67; 0.48–0.93).
Meanwhile, compared with drinking moderate levels of alcohol, never and heavy consumption were associated with an elevated risk of H&Y stage 3 (HRs, 3.48 [1.90–6.38] and 2.16 [1.03–4.54], respectively).
Finally, previous participation in competitive sports was protective against cognitive decline (HR, 0.46; 0.22‐0.96) and progression to H&Y stage 3 (hazard ratio, 0.42; 95% confidence interval, 0.23‐0.79), as was higher lifetime average physical activity measured by metabolic‐equivalent hours.
Current cigarette smoking was associated with faster cognitive decline (hazard ratio, 3.20; 1.02–10.01).
“Lifestyle factors may contribute to the development of PD, but little is known about factors that influence progression,” the authors noted. “Although replication is needed, our study suggests that multiple lifestyle factors potentially modify the rate of symptom progression, as measured by signs of dysfunction (H&Y 3 status and 4‐point MMSE decline), among PD patients.”
Conversion to H&Y stage 3 is a common cutoff point used in PD, signifying the point at which disability advances from mild to moderate, with the appearance of postural instability, as the authors pointed out. On the other hand, while not all changes in MMSE score reflect true clinical changes, changes of 3–4 points over longer intervals provide sufficient confidence that an individual has experienced a functional cognitive change.
“Identifying factors that prevent or slow progression may add to our understanding of neuroprotective mechanisms and ultimately inform future research and treatment,” they added.