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.

便秘是早期 PD 的一个常见但不是普遍特征，这表明肠道受累是异质的，可能是具有预后意义的不同 PD 亚型的一部分。我们分析了来自帕金森病发病率队列协作的数据，该数据由经过 8 年纵向评估的基于社区的 PD 患者队列组成。使用 MDS-UPDRS 便秘项目或类似的分类量表评估便秘。感兴趣的主要 PD 结果是痴呆、姿势不稳和死亡。根据诊断时便秘的严重程度对 PD 患者进行分层：无（n  = 313, 67.3%）、轻微（n  = 97, 20.9%）和严重（n = 55, 11.8%)。在基线时便秘较严重的患者中，所有三种结果的临床进展都更快（Kaplan-Meier 生存分析）。调整相关混杂因素的 Cox 回归分析证实，便秘严重程度与痴呆进展之间存在显着关系，但与姿势不稳或死亡无关。早期便秘可能预示着神经退行性病变的加速进展。