Osteoarthritis Associated With Elevated Risk of Parkinson Disease

Individuals with osteoarthritis (OA) are at higher long-term risk of developing Parkinson disease (PD), according to findings published in Arthritis Care & Research.

Researchers hypothesized that individuals with OA might be at higher risk of developing PD based on literature reporting that the peripheral inflammation associated with OA may cause neuroinflammation in the brain, leading to the neurodegeneration associated with PD. The current study was the first large-scale, population-based, longitudinal follow-up study to suggest a link between OA and PD.

The investigators recruited participants for an OA group and a comparison group from a nationally representative sample using Taiwan’s Longitudinal Health Insurance Database from 2005. The OA group was comprised of 33,360 patients who were aged 50 to 64 years and who had OA in 2002-2005, while the comparison group was comprised of 33,360 age- and sex-matched randomly sampled participants who did not have OA.

Using the Kaplan-Meier method, researchers generated the participants’ PD-free survival curves. They estimated the effect of having OA on patients’ subsequent risk of PD by applying multivariable Cox proportional hazard regression analysis.

Findings from the study showed:

• The OA group had a 41% higher risk of developing PD than the comparison group (adjusted HR [aHR], 1.41; 95% CI, 1.16-1.70; P = .0003).
• The PD-free survival rate of the OA group was significantly lower than that of the comparison group (P = 0.0004).
• Patients with knee or hip OA seemed to have a higher magnitude of PD risk (aHR, 1.55; 95% CI, 1.14-2.11) than patients with nonknee and nonhip OA (aHR, 1.42; 95% CI, 1.06-1.89) or with uncategorized OA (aHR, 1.32; 95% CI, 1.05-1.64). Individuals with knee and hip OA may be less likely to engage in physical activity since the knees and hips are major weight-bearing joints, which may contribute to the higher risk of PD.
• Key proinflammatory cytokines interleukin-6 and tumor necrosis factor-α were found in participants with OA. Both cytokines can elicit neuroinflammation and accelerate neurodegeneration, which may leave individuals predisposed to a higher risk of PD.
• Patients with OA had low serum vitamin D levels and a high prevalence (24%-81%) of vitamin D deficiency. Chronic insufficiency of vitamin D may further the degeneration of dopaminergic neurons, making individuals more susceptible to the development of PD.

Researchers concluded that OA is associated with an increased risk of developing PD. Clinicians treating patients with the disease should be vigilant of this finding when administering care, as early motor symptoms of PD like short stride and slow movement may be masked by OA-related mobility impairments.

“Coexisting osteoarthritis and Parkinson’s disease can additively increase the risk of falling. Moreover, osteoarthritis-related mobility impairments may mask early motor symptoms of Parkinson’s disease,” said senior author Shin-Liang Pan, MD, PhD, of National Taiwan University, in a statement. “Health professionals need to be alert to the potential link between these two diseases.”

Reference

Feng SH, Chuang HJ, Yeh KC, Pan SL. Osteoarthritis is associated with an increased risk of Parkinson’s disease: a population-based, longitudinal follow-up study. Arthritis Care Res (Hoboken). Published online June 8, 2021. doi:10.1002/acr.24708