PTSD a Parkinson's Disease Risk Factor in Men?

Megan Brooks

August 10, 2022

Men with posttraumatic stress disorder (PTSD) have an increased risk of developing Parkinson's disease (PD) and need close monitoring for timely treatment, new research suggests.

The risk is highest in men diagnosed with PTSD at age 72 or later, suggesting that PTSD in older men may be a prodromal symptom of Parkinson's, they suggest.

The study was published online August 4 in JAMA Network Open.

The findings are based on data from Maccabi Health Care Services, the second largest health plan in Israel.

Causal Link?

Yael Barer with Maccabitech, Tel Aviv, Israel and colleagues identified 8336 patients (52% men) diagnosed with PTSD at a mean age of 56 years and matched them with 8336 patients without PTSD. Both groups were followed for an average of about 10 years.

PD developed in 117 patients with PTSD (1.4%) and 79 without PTSD (0.9%).

Compared with patients not having PTSD, those with the disorder had a 48% increased risk of developing PD (adjusted hazard ratio [HR]: 1.48; 95% CI, 1.10 - 1.99; P = .01).

In further analyses stratified by age and sex, men diagnosed with PTSD at age 72 or older had a nearly twofold higher risk for PD than younger men (HR: 1.95; 95% CI 1.16 to 3.28; P = .01).

The findings are in line with the results of a recent study among male US veterans, which showed a 2.7-fold excess risk for PD in association with PTSD.

The investigators note that the association between PTSD and PD in older men was "robust" and not affected by adjustments for depression and traumatic lifetime events, such as the Holocaust and experiencing terror attacks.

The association between PTSD and PD in women was not significant. However, a 2017 study in a predominantly female cohort found a 3.46-fold increased risk for PD in patients with history of PTSD.

The investigators note that emotional and physical stress have been linked to PD risk, although the causal association between stress or anxiety and PD has not been fully established.

A 2014 study showed that adjustment disorder, an emotional or behavioral reaction to a stressful event, was associated with increased risk for PD.

A separate study showed that an anxious personality increases the risk for PD in men by twofold and by 1.76-fold in people aged 50-69 years.

Depression and anxiety are well recognized prodromal symptoms of PD.

Barer and colleagues say their observation that PTSD diagnosed in men older than age 72 was associated with an increased risk of developing PD later in life suggests that PTSD could be a prodromal symptom of PD.

Whether that's true warrants further investigation. Further research is also needed to determine whether treatment for PTSD and stress can reduce the risk or rate of progression for PD.

The study had no specific funding. Barer has reported no relevant financial relationships.

JAMA Netw Open. Published online August 4, 2022. Full text

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