Observational studyJournal of neurology2026
Is Parkinson's disease getting older? Demographic and modifiable determinants of age at onset in a large Italian tertiary care cohort.
Observational study in Journal of neurology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundParkinson's disease (PD) is a heterogeneous neurodegenerative disorder, with age at onset (AAO) influenced by genetic and environmental factors. This study aimed to (i) examine temporal trends in PD AAO over the past four decades in a large tertiary care cohort; and (ii) identify independent associations between AAO and a comprehensive set of demographics, cardiovascular/dysmetabolic, lifestyle, and environmental variables.
methodsWe conducted a retrospective observational study of 13,220 individuals diagnosed with PD between 1998 and 2024 at a tertiary referral center in Italy, excluding genetically confirmed cases. Demographic, clinical, and exposure data were collected via questionnaires and interviews. Temporal trends in AAO were analysed in relation to national population ageing. Independent predictors of AAO were identified using multivariable linear regression with cross-validation and multiple imputation. Age- and sex-stratified analyses were also performed.
resultsAAO increased over time in parallel with demographic ageing (R
conclusionsWhile demographic ageing largely accounts for the temporal increase in AAO, modifiable exposures, particularly cardiovascular/dysmetabolic comorbidities and environmental toxins, can significantly influence disease timing, though causal interpretation is limited by accumulation bias.
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