Smoking, Caffeine, and Nonsteroidal Anti-inflammatory Drugs in Families With Parkinson Disease

Abstract

To assess associations between Parkinson disease (PD) and putatively protective factors-smoking, caffeine (coffee, tea, and soft drinks), and nonsteroidal antiinflammatory drugs (aspirin, ibuprofen, and naproxen). Design: Family-based case-control study. Setting: Academic medical center clinic. Participants: A total of 356 case subjects and 317 family controls who self-reported environmental exposures. Main Outcome Measures: Associations between PD and environmental measures (history, status, dosage, duration, and intensity) of smoking, coffee, caffeine, nonsteroidal anti-inflammatory drugs, and nonaspirin nonsteroidal anti-inflammatory drugs were examined using generalized estimating equations with an independent correlation matrix while controlling for age and sex. Results: Individuals with PD were significantly less likely to report ever smoking (odds ratio=0.56; 95% confidence interval,0.41-0.78).Additionalmeasuresofsmokingrevealed significant inverse associations with PD (PϽ.05) and trends in odds ratios (PϽ.005). Increasing intensity of coffee drinking was inversely associated with PD (test for trend P=.05). Increasingdosage(trendP=.009)andintensity(trendP=.01) of total caffeine consumption were also inversely associated, with high dosage presenting a significant inverse association for PD (odds ratio=0.58; 95% confidence interval, 0.34-0.99). There were no significant associations between nonsteroidal anti-inflammatory drugs and PD. Conclusions: Inverse associations of smoking and caffeine were corroborated using families with PD, thus emphasizing smoking and caffeine as important covariates to consider in genetic studies of PD.

Epidemiology and etiology of Parkinson’s disease: a review of the evidence

“…As mentioned above, the two largest such studies confirmed the inverse association and also reported a dose-response relationship, indicating that confounding by genetic factors is unlikely [427,435]. Similarly, a case-control study that used siblings as controls reported a significant inverse association between smoking and PD with a dose-response relationship [447], a result that was confirmed in an expanded dataset [448].…”

“…Two population-based case-control studies [560,561] and a family-based case-control study [448] found no association between NSAIDs or aspirin and PD. A hospital-based study, in which most controls were spouses or relatives of PD cases, reported lower PD risk associated with use of over the counter NSAIDs (OR 0.81, 95% CI 0.67-0.98 for ever versus never use), with no dose-response relationship [416].…”

Cost‐effectiveness of increasing the reach of smoking cessation interventions in Germany: results from the EQUIPTMOD

“…For missing inputs, Cochrane effectiveness inputs from a wide range of studies world‐wide were used, and represented rigorous and well‐accepted evidence. Some reported but controversial protective effects of smoking, such as those regarding Parkinson disease 63, 64, 65, 66, 67, 68, 69, 70, 71, were not accounted for in this model. Some diseases attributable to smoking 5 were also not included in the model, as the true impact of smoking could not be estimated, and some interventions available only in the United Kingdom but not in Germany were also not considered.…”

Inflammation in Parkinson’s Disease: Causes and Consequences

“…Large scale epidemiological studies have shown that the chronic use of non-steroidal anti-inflammatory drugs (NSAID) such as aspirin or ibuprofen could provide some level of protection against PD (Chen et al, 2005;Chen et al, 2003). Other studies suggest that the role of NSAIDs in decreasing the risk of PD is extremely limited (Hancock et al, 2007;Hernan et al, 2006). A recent meta-analysis of studies published between 1966 and 2008 showed that while NSAIDs as a class do not modify the risk of developing PD, the chronic intake of ibuprofen may have a beneficial effect (Gagne & Power, 2010;Gao et al, 2011;Samii et al, 2009).…”