Abstract
A wide spectrum of comorbidities has been associated with Parkinson’s disease (PD), a progressive neurodegenerative disease that affects more than seven million people worldwide. Emerging evidence indicates that chronic diseases including diabetes, depression, anemia and cancer may be implicated in the pathogenesis and progression of PD. Recent epidemiological studies suggest that some of these comorbidities may increase the risk of PD and precede the onset of motor symptoms. Further, drugs to treat diabetes and cancer have elicited neuroprotective effects in PD models. Nonetheless, the mechanisms underlying the occurrence of these comorbidities remain elusive. Herein, we discuss the biological and clinical implications of comorbidities in the pathogenesis, progression, and clinical management, with an emphasis on personalized medicine applications for PD.
Highlights
A wide spectrum of comorbidities has been associated with Parkinson’s disease (PD), a progressive neurodegenerative disease that affects more than seven million people worldwide
This study suggested that de novo anemic patients might develop PD four or more years after the initial diagnosis of anemia (Hong et al, 2016)
The increasing number of studies suggesting that other diseases including diabetes, depression, anemia and cancer may be associated with PD strengthens the importance of a system-level understanding of PD and its comorbidities
Summary
Diabetes is associated with a higher than 50% increased risk of PD in men and women. Diabetes is associated with an increased risk of PD in men. A double-blinded and placebocontrolled trial showed that treatment with exenatide improved motor symptoms in PD patients in an off-medication state compared with those given placebo (Athauda et al, 2017a,b) These drugs are attractive due to their capacity to cross the blood brain barrier and participate in several biological pathways within the central nervous system including, neuroinflammation, mitochondrial function and brain insulin resistance (Aviles-Olmos et al, 2014). PD is more prevalent in men than in woman (de Lau and Breteler, 2006; Ascherio and Schwarzschild, 2016) Despite these differences, epidemiological studies have not identified any sex-specific factors in the risk of developing PD among anemic patients. Retrospective, Cohort study, Danish registry Retrospective, Case-control, National Hospital Register Australian cancer Danish
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