Application of a Simple Parkinson's Disease Risk Score in a LongitudinalPopulation‐BasedCohort

Abstract

Background Identifying individuals at risk of developing Parkinson's disease (PD) is critical to define target populations for future neuroprotective trials. Objective The objective of this study was to apply the PREDICT‐PD algorithm of risk indicators for PD in a prospective community‐based study (the Bruneck study), representative of the general elderly population. Methods PREDICT‐PD risk scores were calculated based on risk factor assessments obtained at baseline (2005, n = 574 participants). Cases of incident PD were identified at 5‐year and 10‐year follow‐ups. Participants with PD or secondary parkinsonism at baseline were excluded (n = 35). We analyzed the association of log‐transformed risk scores with the presence of well‐established markers as surrogates for PD risk at baseline and with incident PD at follow‐up. Results A total of 20 participants with incident PD were identified during follow‐up (11 after 5 years and 9 after 10 years). Baseline PREDICT‐PD risk scores were associated with incident PD with odds ratios of 2.09 (95% confidence interval, 1.35–3.25; P = 0.001) after 5 years and of 1.95 (1.36–2.79; P < 0.001) after 10 years of follow‐up per doubling of risk scores. In addition, higher PREDICT‐PD scores were significantly correlated with established PD risk markers (olfactory dysfunction, signs of rapid eye movement sleep behavior disorder and motor deficits) and significantly associated with higher probability for prodromal PD according to the Movement Disorder Society research criteria at baseline. Conclusions The PREDICT‐PD score was associated with an increased risk for incident PD in our sample and may represent a useful first screening step in future algorithms aiming to identify cases of prodromal PD. © 2020 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

Evaluation of the PREDIGT Score in Discriminating Parkinson Disease from Neurological Health

“…With securing access to other cohorts' data sets in the future, we plan to assess the PREDIGT Score's discriminative performance in a similar, case-control manner (e.g., EPIPARK, 24 Harvard Biomarker Study ). We will also undertake the task of assessing its predictive performance in prospective, longitudinal studies of neurologically healthy persons, who were enrolled after having been identified as carrying one or more risk factor, a key emphasis in our field, as highlighted by Noyce et al 25 There, we will seek to interrogate results from those ongoing, (Oxford Parkinson's Disease Centre study); 29 PREDICT-PD; 30 Bruneck; 31 and Luxembourg…”

“…g ., EPIPARK, 24 Harvard Biomarker Study 22 ). We will also undertake the task of assessing its predictive performance in prospective, longitudinal studies of neurologically healthy persons, who were enrolled after having been identified as carrying one or more risk factor, a key emphasis in our field, as highlighted by Noyce et al 25 There, we will seek to interrogate results from those ongoing, regional cohorts where sufficient data on variables needed for the calculation of the PREDIGT Score have been collected, such as in: PRIPS (Prospective validation of risk factors for the development of Parkinson syndromes); 26 TREND (Tübingen-based evaluation of risk factors in the early detection of neurodegeneration); 27 PARS (Parkinson At-Risk Syndrome); 28 OPDC (Oxford Parkinson’s Disease Centre study); 29 PREDICT-PD; 30 Bruneck; 31 and Luxembourg Parkinson’s Study. 32…”

Prodromal Parkinson's disease: hype or hope for disease-modification trials?

“…The PREDICT-PD algorithm incorporates remotely-assessable early non-motor features and risk factors combined into a risk score that in the original study was associated with incident PD during follow-up over 3 years with a hazard ratio of 4.4 [ 27 ]. Two validation attempts showed weaker, but significant associations of the score with incident PD, with odds ratios of 1.3–2.1 [ 30 , 31 ]. An enhanced PREDICT-PD risk score has recently been developed that integrates three additional markers and showed better accuracy in predicting PD compared with the original score [ 32 ].…”

Probing the Pre-diagnostic Phase of Parkinson's Disease in Population-Based Studies

“…If we again take the example of the association between diet and PD, appropriate adjustment for smoking is necessary because smoking behavior is associated with both diet and PD risk and thus could be a confounder in this association (39,45). In addition, broad data collection provides the opportunity to study the interdependence of markers of pre-diagnostic PD (46,47) and to combine multiple markers in a prediction algorithm for PD (48)(49)(50)(51)(52)(53)(54), such as the PREDICT-PD algorithm (55,56) and the naïve Bayesian classifier approach of the MDS research criteria for prodromal PD (54). Finally, the large datasets of population-based studies offer possibilities to study the combined effect of multiple risk factors on PD, as well as on clusters of chronic diseases (57), which is essential given that many risk factors and chronic diseases co-occur.…”