Objective: To evaluate the association of anti-hypertensives, non-steroidal anti-inflammatories (NSAIDs), statins, diabetes medications, smoking and family history of idiopathic Parkinson’s disease (iPD) with age of onset (AOO) in a large iPD cohort.

Background: Several factors have been shown to modify the risk of developing iPD, however there is little data describing their correlation with the AOO of clinical symptoms. We investigated the relationship between factors associated with iPD risk and disease AOO.

Method: A retrospective review of 1202 initial iPD encounters at Cedars-Sinai Medical Center from October 2010 to December 2021 collected information on known risk-modulating factors for PD, including smoking status and family history, anti-hypertensives, statins, in addition to NSAIDs and diabetes medications. In addition to general exposure, we determined whether medications of interest were started before or after onset of symptoms. Mean AOO was calculated for each set of variables. T-test and multiple regression analyses were used to evaluate association with AOO.

Results: All studied variables showed a mild, yet statistically significant positive correlation with AOO, except for smoking and family history which correlated with younger AOO. Average AOO for patients who were on adrenergic blockers (AB) was 72.1±9.9 years, as compared with those not on adrenergic blockers (62.7±10.7, p<0.0001) or those who started taking them after onset of symptoms (63.0±10.6, p<0.0001). Similar differences were found for ACE inhibitors/ARBs (69.5±8.7 versus 62.8±11.02), calcium channel blockers (71.5±9.9 versus 63.1±10.9), diuretics (70.5±9.6 versus 63.3±10.9), statins (70.8±8.3 versus 61.7±11.1), and NSAIDs (70.6±8.2 versus 62.3±11.1), all with a significance of p<0.0001, and diabetes medications (68.5±9.8 versus 63.7±10.9) with significance of p<0.01. Recent smoking history and family history of PD were associated with earlier AOO, which averaged at 59.2±10.3 years versus 64±10.8 years (p<0.01) and 61.8±10.2 years versus 64.4±11.1 years (p<0.001), respectively. Multiple regression analysis identified AB (β=5.4), statins (β= 6.0), and smoking (β= -5.1) as the strongest independent predictors of AOO (p<0.001).

Conclusion: AB, statins, NSAIDs, and calcium channel blockers all appear to possibly delay iPD onset, while smoking and family history of PD are associated with earlier AOO.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/adrenergic-blockers-and-statins-are-associated-with-later-age-of-onset-in-parkinsons-disease/