ArticleMovement disorders : official journal of the Movement Disorder Society2026
Risk Factors for the Diagnosis of Progressive Supranuclear Palsy in the UK Biobank.
Article in Movement disorders : official journal of the Movement Disorder Society, 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
backgroundProgressive supranuclear palsy (PSP) is a tauopathy for which there is limited understanding of epidemiological risk factors.
objectiveThe objective of this study was to identify premorbid nonmedical and medical risk factors for PSP diagnosis in a large prospective population-based cohort.
methodsWe performed a matched nested case-control study using the UK Biobank (UKB) cohort consisting of >500,000 adults aged 37 to 73 years. PSP diagnoses were identified from 2007 to censor date (August 2025) and matched 1:10 by age and sex to control subjects without parkinsonism or dementia diagnoses. We derived risk factors using an iterative logistic regression approach.
resultsThere were 240 incident PSP diagnoses in the UKB. In the fully adjusted model, premorbid depression (odds ratio [OR], 3.22; 95% confidence interval [CI], 2.30-4.50; P < 0.001), delirium (OR, 6.76; 95% CI, 4.08-11.19; P < 0.001), and functional gastrointestinal disorders (OR, 1.91; 95% CI, 1.39-2.63; P < 0.001) were associated with increased risk. Heavy alcohol consumption was associated with higher risk compared with moderate consumption (OR, 1.65; 95% CI: 1.21-2.26; P = 0.0017). Body mass index (BMI) and alcohol consumption had nonlinear risk profiles. Cancer diagnosis was inversely associated with PSP (OR, 0.56; 95% CI, 0.40-0.79; P < 0.001). Depression and delirium diagnoses remained significant 5 to 10 years before diagnosis.
conclusionsIn this large prospective cohort, PSP was associated with premorbid lifestyle practices and neuropsychiatric diagnoses years before diagnosis. This suggests a long premotor phase and highlights opportunities for earlier diagnosis and further mechanistic investigation. The inverse association with cancer mirrors the relationship seen in other neurodegenerative conditions and may point toward shared mechanisms. © 2026 International Parkinson and Movement Disorder Society.
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