Adrenergic blockers, statins, and non-steroidal anti-inflammatory drugs are associated with later age at onset in Parkinson's disease.

Abstract

Background: Several factors have been shown to modify the risk of developing Parkinson's disease (PD), including commonly prescribed medications. However, there is little data describing their correlation with age at onset (AAO) of clinical symptoms. The objective of this study was to evaluate the association of treatment with anti-hypertensives, non-steroidal anti-inflammatories (NSAIDs), statins, as well as smoking and family history of PD with AAO in a large clinical cohort.

Methods: A retrospective review of 1201 initial encounters collected information on known risk-modulating factors for PD, including smoking status and family history, anti-hypertensives, statins, NSAIDs, anti-diabetic medications, and beta-agonists. In addition to general exposure, we determined whether medications of interest were started before or after onset of symptoms. Mean AAO was calculated for each set of variables. T-test and multiple regression analyses were used to evaluate association with AAO.

Results: Exposure to all studied medications showed a strong correlation with older PD AAO, except for smoking and family history, which correlated with younger AAO. Multiple regression analysis identified exposure to adrenergic blockers (AB) (β = 5.7), statins (β = 5.6), and NSAIDs (β = 4.1) as the strongest independent predictors of older PD AAO (p < 0.001). Patients who were started on AB prior to onset of PD symptoms showed the largest average delay of PD AAO (at 72.3 ± 10.1 years), almost 10 years later as compared with those not on AB (62.7 ± 10.7 years) or those who started taking AB after onset of symptoms (63.0 ± 10.6 years).

Conclusions: Multiple common medications are associated with a considerable delay of PD onset.