Constipation is a common but not a universal feature in early PD, suggesting that gut involvement is heterogeneous and may be
part of a distinct PD subtype with prognostic implications. We analysed data from the Parkinson’s Incidence Cohorts Collaboration,
composed of incident community-based cohorts of PD patients assessed longitudinally over 8 years. Constipation was assessed
with the MDS-UPDRS constipation item or a comparable categorical scale. Primary PD outcomes of interest were dementia, postural
instability and death. PD patients were stratified according to constipation severity at diagnosis: none (n = 313, 67.3%), minor (n =
97, 20.9%) and major (n = 55, 11.8%). Clinical progression to all three outcomes was more rapid in those with more severe
constipation at baseline (Kaplan–Meier survival analysis). Cox regression analysis, adjusting for relevant confounders, confirmed a
significant relationship between constipation severity and progression to dementia, but not postural instability or death. Early
constipation may predict an accelerated progression of neurodegenerative pathology CLICK TO REVIEW