Inflammatory Bowel Disease and Parkinson's Disease: A Nationwide Swedish Cohort Study

Weimers P1, Halfvarson J2, Sachs MC3, Saunders-Pullman R4, Ludvigsson JF5,6, Peter I7, Burisch J1, Olén O8,9,10. Inflamm Bowel Dis. 2018 May 16. doi: 10.1093/ibd/izy190. [Epub ahead of print]

Author information

1 Department of Gastroenterology, North Zealand University Hospital, Frederikssund, Denmark.

2 Department of Gastroenterology, Faculty of Medicine and Health, Örebro University, Örebro, Sweden.

3 Unit of Biostatistics, Institute of Environmental Medicine, Stockholm, Sweden.

4 Department of Neurology, New York, USA.

5 Department Medical Epidemiology and Biostatistics, Stockholm, Sweden.

6 Department of Pediatrics, Örebro University Hospital, Örebro, Sweden.

7 Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, New York, USA.

8 Clinical Epidemiology Unit, Department of Medicine Solna, Stockholm, Sweden.

9 Department of Pediatric gastroenterology and nutrition, Sachs' Children and Youth Hospital, Stockholm, Sweden.

10 Department of Clinical Science and Education Södersjukhuset, Karolinska Institutet, Stockholm, Sweden.


BACKGROUND: Few studies have examined the association between inflammatory bowel disease (IBD) and Parkinson's disease (PD).

METHODS: To estimate the incidence and relative risk of PD development in a cohort of adult IBD, we included all incident IBD patients (n = 39,652) in the Swedish National Patient Register (NPR) between 2002 and 2014 (ulcerative colitis [UC]: n = 24,422; Crohn's disease [CD]: n = 11,418; IBD-unclassified [IBD-U]: n = 3812). Each IBD patient was matched for sex, age, year, and place of residence with up to 10 reference individuals (n = 396,520). In a cohort design, all incident PD occurring after the index date was included from the NPR. In a case-control design, all incident PD occurring before the index date was included. The association between IBD and PD and vice versa was investigated by multivariable Cox and logistic regression.

RESULTS: In IBD, there were 103 cases of incident PD, resulting in hazard ratios (HRs) for PD of 1.3 (95% confidence interval [CI], 1.0-1.7; P = 0.04) in UC, 1.1 (95% CI, 0.7-1.7) in CD, and 1.7 (95% CI, 0.8-3.0) in IBD-U. However, these effects disappeared when adjusting for number of medical visits during follow-up to minimize potential surveillance bias. In a case-control analysis, IBD patients were more likely to have prevalent PD at the time of IBD diagnosis than matched controls, with odds ratios of 1.4 (95% CI, 1.2-1.8) in all IBD patients, 1.4 (95% CI, 1.1-1.9) for UC, and 1.6 (95% CI, 1.1-2.3) for CD patients alone.

CONCLUSIONS: IBD is associated with an increased risk of PD, but some of this association might be explained by surveillance bias.

© Copyright 2013-2024 GI Health Foundation. All rights reserved.
This site is maintained as an educational resource for US healthcare providers only. Use of this website is governed by the GIHF terms of use and privacy statement.