Abstract
The global burden of Parkinson's disease (PD) has increased from 2.5 to 6.1 million
since the 1990s. This is expected to rise as the world population ages and lives longer.
With the current consensus on the existence of a prediagnostic phase of PD, which can be divided into a preclinical stage and a prodromal stage, we can better define the risk markers and prodromal markers of PD in the broader
context of PD pathogenesis. Here, we review this pathogenetic process, and discuss
the evidence behind various heritability factors, exposure to pesticides and farming,
high dairy consumption, and traumatic brain injuries that have been known to raise
PD risk. Physical activity, early active lifestyle, high serum uric acid, caffeine
consumption, exposure to tobacco, nonsteroidal anti-inflammatory drugs, and calcium
channel blockers, as well as the Mediterranean and the MIND diets are observed to
lower PD risk. This knowledge, when combined with ways to identify at-risk populations
and early prodromal PD patients, can help the clinician make practical recommendations.
Most importantly, it helps us set the parameters for epidemiological studies and create
the paradigms for clinical trials.
Keywords
Parkinson's disease - prevention - risk factors - prodromal Parkinson - pesticides
- exercise
