The most extensive UK study to date into the condition has identified that hearing loss and epilepsy are potentially early signs of Parkinson’s disease.
The comprehensive study conducted by a team at the Queen Mary University of London is the first UK study of Parkinson’s disease to employ such a diverse population. The team utilised electronic primary healthcare records from over one million people living in East London between 1990 and 2018 to investigate early signs of Parkinson’s disease and potential risk factors.
The study received funding from Bart’s Charity and is published in JAMA Neurology.
Exploring early signs of Parkinson’s disease
The team discovered that some symptoms closely associated with the condition, such as tremors and memory issues, can present up to ten and five years before a diagnosis, respectively. Moreover, the researchers also found two new signs of Parkinson’s disease – hearing loss and epilepsy – replicating their findings using additional data from the UK Biobank.
Although the early signs of Parkinson’s disease are well-documented, these investigations have predominantly analysed affluent white populations; people from minority ethnic groups and areas of high social deprivation are underrepresented in most Parkinson’s research. This novel study provides unprecedented insights and evidence into precursors and risk factors for the disease from a diverse and deprived urban population for the first time.
Parkinson’s disease risk factors
Hypertension and Type 2 diabetes were associated with an increased risk of developing Parkinson’s disease in East London; a stronger association was found between memory complaints in this group than previously observed. East London has one of the highest proportions of Black, South Asian, and other mixed/ethnic groups, which comprise 45% of residents in the area, compared to 14% in the rest of the UK. Furthermore, 80% of the study’s participants were from low-income households.
Lead study author Dr Cristina Simonet, neurologist and PhD student at the Queen Mary University of London, commented: “This is the first study focusing on the pre-diagnostic phase of Parkinson’s in such a diverse population with high socioeconomic deprivation but universal access to health care. People from minority ethnic groups and deprived areas have largely been underrepresented in Parkinson’s research up till now, but to allow us to get a full picture of the condition, we need to ensure research is inclusive and represents all those affected.
“Our results uncovered novel risk factors and early symptoms: epilepsy and hearing loss. Whilst previous research has hinted at the association, such as epilepsy being more prevalent in Parkinson’s patients than in the general population, more research is now needed for us to fully understand the relationship. In the meantime, it’s important that primary care practitioners are aware of these links and understand how early the symptoms of Parkinson’s can appear so that patients can get a timely diagnosis and doctors can act early to help manage the condition.”
Dr Alastair Noyce, reader in neurology and neuroepidemiology at the Queen Mary University of London, who is also an author on the new research, added: “People see their GPs with symptoms but often don’t get a diagnosis until five to ten years after this. Tremor, for example, is one of the most recognisable symptoms of Parkinson’s – but was seen ten years before eventual diagnosis in our study. This is too long for patients to wait. If we’re able to diagnose Parkinson’s earlier, we have a real opportunity to intervene early and offer treatments that could improve the quality of life for patients.
“This study confirms that many of the symptoms and early features of Parkinson’s can occur long before a diagnosis. Through our ongoing PREDICT-PD research, we’re hoping to identify people at high risk of Parkinson’s even before obvious symptoms appear – which means that we could do more than just improve quality of life for patients, and perhaps be in the position to slow down or cure Parkinson’s in the future.”
Parkinson’s UK fund PREDICT-PD, which is a large research project aiming to identify people at an elevated risk of developing the disease and are looking for 10,000 people aged 60-80 years from a range of backgrounds who do not have Parkinson’s to partake in a series of simple online tests that screen for known risk factors.
Shafaq Hussain-Ali, a former native East Londoner of Pakistani Punjabi descent who was diagnosed with young-onset Parkinson’s three years ago and is a member of Parkinson’s UK Race Equality Steering Group, said: “Parkinson’s affects everyone, regardless of race or social background, but research has often failed to represent the diversity of the community. This research and the work that Parkinson’s UK is leading helps address the many unknowns regarding how the condition affects people from under-represented groups. It means that life-changing new treatments can be developed that will benefit everyone with the condition.
“I want to get the message out that young Asian people like myself can be affected by this condition and that more people are likely to be affected by young-onset Parkinson’s in the future. Getting an early diagnosis can make such a difference to the quality of life and Parkinson’s progression. With appropriate management, you can carry on living well and have a productive life. I am still a practising dentist who enjoys swimming, walking and Kung Fu. I also still love doing my crochet!”