scholarly journals Polypharmacy and Hyperpolypharmacy in Older Individuals with Parkinson’s Disease: A Systematic Review and Meta-Analysis

Gerontology ◽  
2022 ◽  
pp. 1-10
Author(s):  
Akshaya Srikanth Bhagavathula ◽  
Wubshet Tesfaye ◽  
Kota Vidyasagar ◽  
Daniela Fialova
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Observational Studies ◽  
Meta Analysis ◽  
Adverse Outcomes ◽  
Older Individuals ◽  
Drug Related Problems ◽  
Inclusion Criteria ◽  
Pooled Prevalence

<b><i>Background and Aim:</i></b> Polypharmacy (concomitant use of 5–9 medicines) and hyperpolypharmacy (concomitant use of over 10 medicines) were observed to be more frequent in older adults (≥65 years) and associated with adverse outcomes. Their prevalence and risk in older patients with Parkinson’s disease (PD) remain unknown. We aimed to synthesize the extant evidence on the prevalence and risk of polypharmacy and hyperpolypharmacy in older adults with PD. <b><i>Methods:</i></b> A systematic literature search was performed in PubMed/MEDLINE, Scopus, and Embase databases to identify pertinent studies published from 2000 to July 2021. Observational studies reporting the prevalence and association with disease of polypharmacy/hyperpolypharmacy in older adults with PD were meta-analyzed. Pooled prevalence and odds ratio (OR) with 95% confidence intervals (CIs) were calculated. <b><i>Results:</i></b> Out of the total 499 studies identified, 6 fulfilled the inclusion criteria and comprised 7,171 participants. The overall prevalence of polypharmacy and hyperpolypharmacy was 40% (95% CI: 37–44) and 18% (95% CI: 13–23), respectively. A meta-analysis of 4 studies indicated a significant association between polypharmacy (OR: 1.94, 95% CI: 1.26–2.62; <i>p</i> &#x3c; 0.001) and PD. Hyperpolypharmacy was also strongly associated with PD (OR: 3.11, 95% CI: 2.08–4.14; <i>p</i> &#x3c; 0.001). <b><i>Conclusion:</i></b> Polypharmacy (40%) and hyperpolypharmacy (18%) are highly prevalent and eventually increase the risk of drug-related problems in older adults with PD. Therefore, interventions that ensure rational geriatric pharmacotherapy are of critical importance for the older population with neurogenerative disorders.

scholarly journals Cannabis and its derivatives for the use of motor symptoms in Parkinson’s disease: a systematic review and meta-analysis

2021 ◽  
Vol 14 ◽  
pp. 175628642110185
Author(s):  
Susan J. Thanabalasingam ◽  
Brandan Ranjith ◽  
Robyn Jackson ◽  
Don Thiwanka Wijeratne
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Motor Function ◽  
Observational Studies ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Motor Symptom ◽  
Quality Data ◽  
Symptom Improvement ◽  
Motor Symptoms

Background: Recent changes to the legal status of cannabis across various countries have renewed interest in exploring its use in Parkinson’s disease (PD). The use of cannabinoids for alleviation of motor symptoms has been extensively explored in pre-clinical studies. Objective: We aim to systematically review and meta-analyze literature on the use of medical cannabis or its derivatives (MC) in PD patients to determine its effect on motor function and its safety profile. Methods: We reviewed and analyzed original, full-text randomized controlled trials (RCTs) and observational studies. Primary outcomes were change in motor function and dyskinesia. Secondary outcomes included adverse events and side effects. All studies were analyzed for risk of bias. Results: Fifteen studies, including six RCTs, were analyzed. Of these, 12/15 (80%) mention concomitant treatment with antiparkinsonian medications, most commonly levodopa. Primary outcomes were most often measured using the Unified Parkinson Disease Rating Scale (UPDRS) among RCTs and patient self-report of symptom improvement was widely used among observational studies. Most of the observational data lacking appropriate controls had effect estimates favoring the intervention. However, the controlled studies demonstrated no significant motor symptom improvement overall. The meta-analysis of three RCTs, including a total of 83 patients, did not demonstrate a statistically significant improvement in UPDRS III score variation (MD −0.21, 95% CI −4.15 to 3.72; p = 0.92) with MC use. Only one study reported statistically significant improvement in dyskinesia ( p < 0.05). The intervention was generally well tolerated. All RCTs had a high risk of bias. Conclusion: Although observational studies establish subjective symptom alleviation and interest in MC among PD patients, there is insufficient evidence to support its integration into clinical practice for motor symptom treatment. This is primarily due to lack of good quality data.

Reproductive factors and risk of Parkinson’s disease in women: A meta-analysis of observational studies

2017 ◽  
Vol 335 ◽  
pp. 103-110 ◽  
Author(s):  
Menglian Lv ◽  
Ying Zhang ◽  
Guo-chong Chen ◽  
Guowei Li ◽  
Yehua Rui ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Observational Studies ◽  
Meta Analysis ◽  
Reproductive Factors

scholarly journals Risk of Parkinson’s Disease in the Users of Antihypertensive Agents: An Evidence from the Meta-Analysis of Observational Studies

2016 ◽  
Vol 2016 ◽  
pp. 1-8 ◽  
Author(s):  
Amarnath Mullapudi ◽  
Kapil Gudala ◽  
Chandra Sekhar Boya ◽  
Dipika Bansal
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Publication Bias ◽  
Observational Studies ◽  
Meta Analysis ◽  
Antihypertensive Agents ◽  
Protective Role ◽  
Large Sample Size ◽  
Significant Heterogeneity ◽  
Channel Blockers

Background. Antihypertensive agents have been shown to inhibit oxidative stress and inflammatory response and thus neuroprotection in Parkinson’s disease (PD). Epidemiological evidence suggests inconsistency between use of antihypertensives and risk of PD. This study is aimed to examine the association between antihypertensive use and risk of PD. Methods. Literature search in PubMed, EMBASE, and PsycINFO database was undertaken through February 2012 looking for observational studies evaluating the association between antihypertensive drug use and risk of PD. Before meta-analysis, the studies were evaluated for publication bias and heterogeneity. Pooled relative risk (RR) estimates and 95% confidence intervals (CIs) were calculated using random-effects model (DerSimonian and Laird method). Subgroup analyses and sensitivity analysis were also performed. Results. Seven relevant studies including a total of 28,32,991 subjects were included. Pooled RR of overall use of antihypertensive agents was found to be 0.95 (95% CI 0.84–1.05). A significant reduction in the risk of PD was observed among users of calcium channel blockers (RR 0.82, 95% CI 0.71–0.93). Significant heterogeneity (I2 = 76.2%) but no publication bias was observed. Conclusions. Overall use of antihypertensive agents showed no significant association with the risk of PD. CCBs provided significant protective role. However, studies with large sample size and dose relationships are required to strengthen our hypothesis.

scholarly journals Potential Role of Vitamin D in the Elderly to Resist COVID-19 and to Slow Progression of Parkinson’s Disease

2020 ◽  
Vol 10 (5) ◽  
pp. 284 ◽  
Author(s):  
Casey A. Hribar ◽  
Peter H. Cobbold ◽  
Frank C. Church
Keyword(s):  
Older Adults ◽  
Parkinson’S Disease ◽  
Vitamin D ◽  
Parkinson's Disease ◽  
Vitamin D3 ◽  
The Elderly ◽  
Vitamin D Supplementation ◽  
Older Individuals ◽  
Related Quality ◽  
Cholecalciferol Supplementation

While we are still learning more about COVID-19, caused by the novel SARS-CoV-2 virus, finding alternative and already available methods to reduce the risk and severity of the disease is paramount. One such option is vitamin D, in the form of vitamin D3 (cholecalciferol) supplementation, due to its potential antiviral properties. It has become apparent that older individuals have a greater risk of developing severe COVID-19, and compared to younger adults, the elderly have lower levels of vitamin D due to a variety of biological and behavioral factors. Older adults are also more likely to be diagnosed with Parkinson’s disease (PD), with advanced age being the single greatest risk factor. In addition to its immune-system-modulating effects, it has been suggested that vitamin D supplementation plays a role in slowing PD progression and improving PD-related quality of life. We completed a review of the literature to determine the relationship between vitamin D, PD, and COVID-19. We concluded that the daily supplementation of 2000–5000 IU/day of vitamin D3 in older adults with PD has the potential to slow the progression of PD while also potentially offering additional protection against COVID-19.

Paraquat and Parkinson’s disease: a systematic review and meta-analysis of observational studies

2019 ◽  
Vol 22 (5-6) ◽  
pp. 172-202 ◽  
Author(s):  
Carolina Vaccari ◽  
Regina El Dib ◽  
Huda Gomaa ◽  
Luciane C Lopes ◽  
João Lauro de Camargo
Keyword(s):  
Systematic Review ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Observational Studies ◽  
Meta Analysis

scholarly journals Serum Urate and the Risk of Parkinson's Disease: Results From a Meta-Analysis

2013 ◽  
Vol 40 (1) ◽  
pp. 73-79 ◽  
Author(s):  
Chunhong Shen ◽  
Yi Guo ◽  
Wei Luo ◽  
Chen Lin ◽  
Meiping Ding
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Web Of Science ◽  
Meta Analysis ◽  
Serum Urate ◽  
High Serum ◽  
Protective Effects ◽  
Inclusion Criteria ◽  
Serum Urate Level

Objective:Serum urate may exert protective effects against Parkinson's disease (PD) through its antioxidant capacities. In this article, we examine the hypothesis that high serum urate levels are associated with lower risk of PD.Methods:We searched NCBI (PubMed), ISI Web of Science and EMBASE for studies that reported the risk of PD associated with serum urate. Fixed or random effects meta-analysis was used to pool results across studies, and further analysis was used to assess the effects by gender.Results:Six studies met the inclusion criteria involving a total of 33 185 participants. Overall, we found a 33% reduction in PD incidence among persons with high serum urate level (relative risk [RR]=0.67; 95% confidence interval [CI], 0.50-0.91). Subgroup analysis was performed with 20 641 men and 12 544 women included, indicating statistically significant protective effects of serum urate in men (RR=0.60; 95% CI, 0.40-0.90) but not in women. A dose-response trend of serum urate to reduce PD risk was also observed involving 11 795 participants (RR=0.77; 95% CI, 0.68-0.88). Additionally, high serum urate levels seemed to slow the clinical decline of PD patients (RR=0.56; 95% CI, 0.43-0.72).Conclusions:In light of these findings, our study confirms previous findings of a robust association between high serum urate level and PD risk, especially in men. It also suggests that long-term exposure to high serum urate may be linked to the delay of PD progression, however more well-designed investigations are needed.

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