Abstract
Background:Previous cross-sectional studies have shown that Parkinson’s disease (PD) patients have lower serum 25-hydroxy vitamin D (25(OH)D) concentrations than controls. Vitamin D deficiency was associated with increased disease severity and cognitive impairment in prevalent PD patients.Objective:The aim of the study was to determine 25(OH)D in newly diagnosed PD and age-matched controls and to assess if there was an association with clinical outcomes (disease severity, cognition and falls) over the 36-month follow up period.Methods:A prospective observational study of newly diagnosed PD patients in the North East of England with age-matched controls (PD, n = 145; control, n = 94). Serum 25(OH)D was assessed at baseline and 18 months. Participants underwent clinical assessment at baseline, 18 and 36 months. One hundred and ten participants with PD also took part in a prospective falls study.Results:Mean serum 25(OH)D concentrations were lower in PD than control participants at baseline (44.1±21.7 vs. 52.2±22.1 nmol/L, p < 0.05) and 18 months (44.2±23.6 vs. 55.7±28.8 nmol/L, p < 0.05). Baseline serum 25(OH)D concentration, age, motor score and dosage of dopaminergic medication were significant predictors of variance of motor severity at 36 months ((ΔR2 = 0.039, F = 6.6, p < 0.01). Serum 25(OH)D was not associated with cognition or falls during the follow up period.Conclusions:Patients with incident PD had significantly lower serum 25(OH)D concentrations than age-matched controls, which may have implications in terms of bone health and fracture risk. There was a small but significant association between vitamin D status at baseline and disease motor severity at 36 months.
Highlights
Idiopathic Parkinson’s disease (PD) is the second most common neurodegenerative disorder in the United Kingdom (UK) after Alzheimer’s disease, with increasing age being the greatest risk factor for the development of the disorder
We have shown that participants with early PD have lower serum concentrations of 25(OH)D than control participants within months of diagnosis, and at 18 months follow-up
Low baseline 25(OH)D concentration was associated with a higher MDSUPDRS III score and greater motor severity at 36 months
Summary
Idiopathic Parkinson’s disease (PD) is the second most common neurodegenerative disorder in the United Kingdom (UK) after Alzheimer’s disease, with increasing age being the greatest risk factor for the development of the disorder. One possible mechanism for the protective effect of outdoor work may be increased exposure to sunlight, which leads to cutaneous vitamin D synthesis This hypothesis is supported by a Finnish study, which showed that middle-aged people with a serum 25-hydroxy vitamin D (25(OH)D) concentration in the highest quartile were a third less likely to develop PD than those in the bottom quartile [2]. A recent study in the United States has failed to confirm the association between mid-life vitamin D status and prospective risk of PD [4] This may be related to the higher population vitamin D levels in the US compared to Finland. Objective: The aim of the study was to determine 25(OH)D in newly diagnosed PD and age-matched controls and to assess if there was an association with clinical outcomes (disease severity, cognition and falls) over the 36-month follow up period. There was a small but significant association between vitamin D status at baseline and disease motor severity at 36 months
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