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CC BY 4.0 · Arq Neuropsiquiatr 2025; 83(03): s00451805075
DOI: 10.1055/s-0045-1805075
Review Article

Modifiable risk factors associated with the risk of developing Parkinson's disease: a critical review

Vitor Tumas 
1   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto SP, Brazil.
,
Marcelo Jhonatan Aureliano 
2   Universidade de São Paulo, Faculdade de Medicina de Ribeirão Preto, Departamento de Neurociências e Ciências do Comportamento, Ribeirão Preto SP, Brazil.
,
Carlos Roberto de Melo Rieder 
3   Universidade Federal de Ciências da Saúde de Porto Alegre, Departamento de Neurologia, Porto Alegre RS, Brazil.
,
Artur Francisco Schumacher Schuh 
4   Universidade Federal do Rio Grande do Sul, Departamento de Farmacologia, Porto Alegre RS, Brazil.
,
Henrique Ballalai Ferraz 
5   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Vanderci Borges 
5   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Maria Carolina Soares 
5   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Dayany Leonel Boone 
5   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Carolina Candeias da Silva 
5   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Mariana Cavalcanti Costa 
5   Universidade Federal de São Paulo, Escola Paulista de Medicina, Departamento de Neurologia e Neurocirurgia, São Paulo SP, Brazil.
,
Delson José da Silva 
6   Universidade Federal de Goiás, Hospital das Clínicas, Centro de Referência em Doença de Parkinson e Transtornos do Movimento (CerMov), Goiânia GO, Brazil.
,
Aracelle Victor do Carmo 
6   Universidade Federal de Goiás, Hospital das Clínicas, Centro de Referência em Doença de Parkinson e Transtornos do Movimento (CerMov), Goiânia GO, Brazil.
,
Luana de Rezende Mikael 
6   Universidade Federal de Goiás, Hospital das Clínicas, Centro de Referência em Doença de Parkinson e Transtornos do Movimento (CerMov), Goiânia GO, Brazil.
,
Bruno Lopes Santos-Lobato 
7   Universidade Federal do Pará, Instituto de Ciências Biológicas, Laboratório de Neuropatologia Experimental, Belém PA, Brazil.
,
Ana Lucia Zuma Rosso 
8   Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil.
,
Celmir de Oliveira Vilaça 
8   Universidade Federal do Rio de Janeiro, Hospital Universitário Clementino Fraga Filho, Serviço de Neurologia Prof. Sérgio Novis, Rio de Janeiro RJ, Brazil.
9   Universidade Federal Fluminense, Niterói RJ, Brazil
,
Pedro Braga-Neto 
10   Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Medicina Clínica, Fortaleza CE, Brazil.
,
André Borges Ferreira Gomes 
10   Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Medicina Clínica, Fortaleza CE, Brazil.
,
Camila Gonçalves Monteiro Carvalho 
10   Universidade Federal do Ceará, Faculdade de Medicina, Departamento de Medicina Clínica, Fortaleza CE, Brazil.
,
Grace Helena Letro 
11   Pontifícia Universidade Católica de Campinas, Centro de Ciências da Vida, Ambulatório de Neurologia Clínica, Setor de Distúrbios do Movimento, Campinas SP, Brazil.
,
Denise Hack Nicaretta 
12   Universidade Federal do Estado do Rio de Janeiro, Escola de Medicina e Cirurgia, Serviço de Neurologia, Rio de Janeiro RJ, Brazil.
,
Marcus Vinicius Della Coletta 
13   Universidade do Estado do Amazonas, Departamento de Neurologia, Manaus AM, Brazil.
,
Egberto Reis Barbosa 
14   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
,
Rubens Gisbert Cury 
14   Universidade de São Paulo, Faculdade de Medicina, Departamento de Neurologia, São Paulo SP, Brazil.
,
Francisco Eduardo Costa Cardoso 
15   Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Medicina Interna, Belo Horizonte MG, Brazil.
,
Sarah Teixeira Camargos 
15   Universidade Federal de Minas Gerais, Faculdade de Medicina, Departamento de Medicina Interna, Belo Horizonte MG, Brazil.
,
Ignacio Fernandez Mata 
16   Cleveland Clinic Foundation, Lerner Research Institute, Genomic Medicine Institute, Cleveland OH, United States.
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Abstract

The etiology of Parkinson's disease (PD) is complex and multifactorial, depending on interactions involving environmental/lifestyle and genetic factors. The genetic aspects of the disease are becoming well characterized, while the environmental factors still need further investigation. In the present narrative review, we have described the most concrete evidence of associations between environmental factors and the risk of developing PD. Physical activity, healthy dietary patterns, smoking, and caffeine intake are protective factors against PD. Head trauma, consumption of milk and dairy products, and pesticide exposure were associated with a higher risk of developing PD. The associations of alcohol consumption, living in rural areas, farming, and consumption of well water with PD are still controversial. Results of several studies strongly suggest that diabetes mellitus is a risk factor for the development of PD, as well as the pre-diabetic state. Lower serum levels of uric acid were associated with an increased risk of developing PD and with worse clinical features and faster progression of symptoms. The protective effects of nonsteroidal antiinflammatory drugs use are controversial. Several other factors were potentially associated with the risk of developing PD: environmental pollutants such as organic solvents, exposure to sunlight, vitamin D deficiency, bullous pemphigoid, bipolar disorder, inflammatory bowel disease, irritable bowel syndrome, certain infections and agents, and essential tremor. Environmental factors are important risk markers for the development of PD. Understanding these risks and protective factors could lead to the implementation of risk-modifying actions for PD.

Keywords

Parkinson Disease - Risk Factors - Etiology - Protective Factors - Environmental Exposure

Authors' Contributions

VT: conceptualization, data curation, formal analysis, investigation, methodology, project administration, supervision, validation, resources, visualization, writing – original draft, and writing – review & editing; AFSS, ALZR, BLSL, CRMR, DHN, DJS, ERB, GHL, HBF, IFM, MVDC, PBN, RGC, and VB: conceptualization, data curation, formal analysis, investigation, methodology, project administration, supervision, validation, writing – original draft, and writing – review & editing; and MJA, MCS, DLB, CCS, MCC, AVC, LRM, COV, ABFG, CGMC, FECC, and STC: investigation, writing – original draft, and writing – review & editing.


Editor-in-Chief: Hélio A. G. Teive.


Associate Editor: Renato Puppi Munhoz.




Publikationsverlauf

Eingereicht: 16. September 2024

Angenommen: 26. November 2024

Artikel online veröffentlicht:
19. März 2025

© 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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Bibliographical Record
Vitor Tumas, Marcelo Jhonatan Aureliano, Carlos Roberto de Melo Rieder, Artur Francisco Schumacher Schuh, Henrique Ballalai Ferraz, Vanderci Borges, Maria Carolina Soares, Dayany Leonel Boone, Carolina Candeias da Silva, Mariana Cavalcanti Costa, Delson José da Silva, Aracelle Victor do Carmo, Luana de Rezende Mikael, Bruno Lopes Santos-Lobato, Ana Lucia Zuma Rosso, Celmir de Oliveira Vilaça, Pedro Braga-Neto, André Borges Ferreira Gomes, Camila Gonçalves Monteiro Carvalho, Grace Helena Letro, Denise Hack Nicaretta, Marcus Vinicius Della Coletta, Egberto Reis Barbosa, Rubens Gisbert Cury, Francisco Eduardo Costa Cardoso, Sarah Teixeira Camargos, Ignacio Fernandez Mata. Modifiable risk factors associated with the risk of developing Parkinson's disease: a critical review. Arq Neuropsiquiatr 2025; 83: s00451805075.
DOI: 10.1055/s-0045-1805075