The PRIAMO study: age- and sex-related relationship between prodromal constipation and disease phenotype in early Parkinson’s disease

Picillo M.; Palladino R.; Erro R.; Alfano R.; Colosimo C.; Marconi R.; Antonini A.; Barone P.; Morgante L.; Benincasa D.; Quatrale R.; Biguzzi S.; Braga M.; Ceravolo G.; Capecci M.; Meco G.; Caravona N.; Scala R.; De Falco F. A.; Pezzoli G.; De Gaspari D.; Bottacchi E.; Di Giovanni M.; Cannas A.; Floris G.; Gallerini S.; Grasso L.; Gaglio R. M.; Gurgone G.; Volpe G.; Zappulla S.; Ceravolo R.; Kiferle L.; Ramat S.; Meoni S.; Pisani A.; Moschella V.; Morgante F.; Savica R.; Pepe F.; Ciccarelli G.; Petretta V.; Giglia R. M.; Randisi M. G.; Iemolo F.; Avarello T. P.; Romeno M.; Santangelo G.; Stocchi F.; Sciortino G.; Sorbello V.; Nicoletti A.; Tiple D.; Fabbrini G.; Bentivoglio A.; Pontieri F. E.; Guidubaldi A.; Muoio R.; Toni V.; Del Dotto P.; Logi C.; Ciacci G.; Ulivelli M.; Perini M.; Lanfranchi S.; Griffini S.; Troianiello B.; Baratti M.; Amidei S.; Consoli D.; Iellamo M.; Cuomo T.; Scaglioni A.; Medici D.; Manfredi M.; Abbruzzese G.; Di Brigida G.; Cocco G. A.; Agnetti V.; Cossu G.; Deriu M.; Abrignani M.; Modica C.; Albani G.; Milan E.; Martinelli P.; Scaglione C.; Mucchiut M.; Zanini S.; Pennisi F.; Soliveri P.; Albanese A.; Massimo P.; Bartolomei L.; Capus L.; Ferigo L.; Marano R.; Nastasi V.; Luciano R.; Maiello L.; Simone P.; Fogli D.; Lopiano L.; Pesare M.; Nordera G.; Pilleri E.; Scaravilli T.; Giaccaglini E.; Alesi C.; Petrone A.; Trianni G.

doi:10.1007/s00415-020-10156-3

Objectives: To explore the impact of sex and age on relationship between prodromal constipation and disease phenotype in Parkinson’s disease at early stages. Methods: A total of 385 Parkinson’s disease patients from the PRIAMO study were classified according to the presence of prodromal constipation and followed for 24 months. Multivariable mixed-effect models were applied. All analyses were performed separately for sex (64.1% men) and median age (different by sex: 67 years-old in men and 68 years-old in women). Results: As for sex, prodromal constipation was associated with greater odds of attention/memory complaints and apathy symptoms in women only. As for age, prodromal constipation was associated with lower cognitive and higher apathy scores in older patients only. Conclusions: Prodromal constipation anticipates lower cognitive performances and more severe apathy since the earliest stages in women and older patients. Sex- and age-related heterogeneity of prodromal markers of Parkinson’s disease may impact disease phenotype.