Are Coffee Nerves in the Short Run Able to Prevent the Tremors of Parkinson Disease in the Long Run?
Abstract & commentary
Synopsis: Both coffee and caffeine intake appeared to protect against the development of Parkinson’s disease.
Source: Ross GW, et al. JAMA 2000;283:2674-2679.
Ross and colleagues of the honolulu heart program may have uncovered yet another "lifestyle" association with Parkinson Disease (PD). The objective of this study was to explore the relationship of coffee and dietary caffeine intake with PD. Coffee and total caffeine intake were analyzed in the large (> 8000 men), long (> 20 years), prospective study. The study controlled for cigarette smoking, cholesterol level, physical activity, energy intake, hypertension, diabetes, and other nutrients in coffee (niacin, cream, sugar). Both coffee and caffeine intake appeared to protect against the development of PD. After 24 years of follow-up, the odds ratio (OR) for nondrinkers of coffee compared with drinkers was 2.9 (CI = 1.7-5.1).
Comment by Barbara Phillips, MD, MSPH
Approximately 1 million Americans, including Mohammad Ali, Janet Reno, and Michael J. Fox, have PD. Internists tend to leave the diagnosis and management of PD to our colleagues in neurology. It behooves us to know about it because PD is a prevalent disorder (affecting 3% of those > 65 in the United States) that has lately received a fair amount of attention in the lay press because of the fame (or notoriety) of some of those afflicted. It is generally considered to be a disease of aging (indeed, the median age of onset in the current study was 73.6 years, range 54-89 years), but Michael J. Fox’s public disclosure of his diagnosis of PD at the age of 30 captured the interest of the media and the public.
PD is a horrible affliction involving gradual deterioration of the lernerve cell clusters that produce dopamine. It results in tremor, bradykinesia, rigidity, and postural instability. It generally responds at least partially to dopaminergic agents, but these drugs have their own problems.
PD is believed to be related to environment and lifestyle, and previous studies have found low rates of PD in "thrill-seeking" people, including cigarette smokers and heavy alcohol drinkers.1-3 Heavy coffee drinking appears to fit in with this overall risk-taking lifestyle.
Ross et al speculate that the low rate of PD in heavy coffee drinkers could be due to a psychological or physiological intolerance to caffeine among people with a constitutional propensity to develop PD. Other possibilities are that caffeine might increase central dopaminergic tone or that people destined to develop PD used caffeine-containing analgesics and reduced coffee to avoid excess caffeine.
Although it is too early to recommend coffee or caffeine as a treatment for PD, it seems like a good idea to have a cup or two in the morning.
References
1. Tanner CM, et al. JAMA 1999;281:341-346.
2. Langston JW. Ann Neurol 1998;44:545-552.
3. Grandinetti I, et al. Am J Epidemiol 1994;139:1129-1138.
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