You can find out more about NPF's National Medical Director, Dr. Michael S. Okun, by also visiting the NPF Center of Excellence, University of Florida Health Center for Movement Disorders and Neurorestoration. Dr. Okun is also the author of the Amazon #1 Parkinson's Best Seller 10 Secrets to a Happier Life.
Recently there has been a surge of interest in cholesterol and cholesterol lowering drugs (statins) and the risk of developing Parkinson’s disease (PD). Patients and families with a personal interest in the outcomes of these studies simply want to know whether they should consider starting a statin medication or they should change their diet. In this months What’s Hot column we will examine the evidence and offer a recommendation for those considering a statin drug.
Statins, plasma lipids, and PD have been shown in previous studies to be possibly related. The major problem with the previous studies is that many patients enrolled in the studies were already taking statin drugs, and these drugs have the expected effect of improving the blood lipid profile. The improvement could have affected the interpretation of the relationship. Huang and colleagues in the January issue of Movement Disorders used the Atherosclerosis Risk in Communities (ARIC) Study data to try to disentangle the questions surrounding statin, plasma lipids, and PD. They examined profiles from four visits over an approximate 10 year epoch. The authors focused on new onset PD cases. Interestingly, the use of statins was less than 1% at the first visit and was 11% at the fourth visit. Total-cholesterol levels declined the most in those taking statins. The use of statins imparted a higher risk of PD even when accounting for cholesterol and other factors. Higher total cholesterol showed a lower risk for PD. These authors concluded that statins did not impart a neuroprotective benefit for the development of PD.
Interestingly, in the February issue of the Journal of Neurology Neurosurgery and Psychiatry, Tan and colleagues examined whether there was an association between dietary cholesterol, major fatty acids, and PD risk in 218 men and 193 women in Singapore who developed PD during a 5 year period. Dietary cholesterol was associated with a lower risk of PD. In women monounsaturated fatty acid was inversely associated with PD risk. The authors suggested the possibility that higher intakes of cholesterol and monounsaturated fatty acids may possibly reduce PD risk.
So what do we tell patients about diet, and about taking statin drugs. The most important point for patients and families is that these lipid and statin studies have been focused on risk factors that may later contribute to a diagnosis of Parkinson’s disease. What this translates to for patients and families is simple: if you already have a diagnosis of PD, “the cat is out of the bag.” Whether you take a statin drug or change your diet it will not change your current Parkinson’s diagnosis. If you do not have Parkinson’s disease and believe you are at increased risk (e.g. a family member is affected or you have a known gene that causes PD) the current evidence does not strongly support the use of a statin drug to prevent PD. Dietary changes may be more reasonable to implement, however the current studies have not really tested specifically whether these dietary changes will have long term beneficial effects. Our best advice for PD patients, families, and those at risk would be to use a statin drug (under the guidance of your general physician) only if needed for lowering cholesterol or for other general health reasons. We cannot yet recommend changing dietary cholesterol intake if you believe you are at risk for developing PD. Any changes in diet should be done only after consulting in person with your doctor as changes in diet could have deleterious consequences on your general health.
1: Tan LC, Methawasin K, Tan EK, Tan JH, Au WL, Yuan JM, Koh WP. Dietary
cholesterol, fats and risk of Parkinson's disease in the Singapore Chinese Health
Study. J Neurol Neurosurg Psychiatry. 2015 Feb 10. pii: jnnp-2014-310065. doi:
10.1136/jnnp-2014-310065. [Epub ahead of print] PubMed PMID: 25669745.
2: Huang X, Alonso A, Guo X, Umbach DM, Lichtenstein ML, Ballantyne CM, Mailman
RB, Mosley TH, Chen H. Statins, plasma cholesterol, and risk of Parkinson's
disease: A prospective study. Mov Disord. 2015 Jan 14. doi: 10.1002/mds.26152.
[Epub ahead of print] PubMed PMID: 25639598.
Posted: 4/1/2015 1:41:18 PM by
Browse current and archived What's Hot in PD? articles, the National Parkinson Foundation's monthly blog for people with Parkinson's written by our National Medical Director, Dr. Michael S. Okun.
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A New Treatment for Parkinson’s Disease-Related Constipation
Too Many Pills: Improving Delivery Systems for Parkinson’s Disease Drugs
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Pill Color, Generic Medications and Insurance Issues: Important Medication-Related Tips for the Parkinson’s Disease Patient
Are Blood Tests for Parkinson’s Disease on the Horizon?
Placing Stem Cells in Animal Models of Parkinson’s Disease: Another Important Step
Important News for the Parkinson’s Disease Community: More Evidence that Sinemet and Madopar are Not Toxic and do Not Accelerate Disease Progression
The Case for All Parkinson’s Disease Patients to be Co-managed by a Primary Care-Neurologist Team
Scientists say Research on Brain Proteins Involved in Parkinson’s Disease is “Shaping” Up
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If you are Dizzy or Passing Out, it could be Your Parkinson’s Disease or Parkinson’s Disease Medications
How Will Group Visits for Parkinson’s Disease Fit into the Future of Parkinson’s Disease Care?
Why Patients Should be Wary of Chelation Therapy for Parkinson’s Disease
Opening the Door to Gene Therapy in Parkinson’s Disease: The Need for Refinement of the Technology and Approach
Does it Matter if I Can’t Get Brand Sinemet?
Should I get a DaTscan or PET scan to confirm my diagnosis of Parkinson’s disease?
A Critical Reappraisal of the Worst Drugs in Parkinson’s Disease
Environmental Risks for PD: Manganese, Welding, Mining, and Parkinsonism
Calling for the FDA to Revise the Eight Sinemet a Day Rule
Dry Cleaning Solvents and Potential Environmental Risks for Developing Parkinson’s Disease
Maintaining the Balance: Why Parkinson’s Disease Patients Need to Understand Drug Recalls, Withdrawals, and Safety Alerts
Shining a Light on Parkinson’s Disease: Optogenetics Has a Bright Future in Research
Poor Medication Management of Parkinson's Disease During Hospital Admissions: Patients and Families Can Improve Their Hospital-Based Management
Why Are Patches and Continuous Release Technology a Big Deal to Parkinson's?
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Time for Comprehensive Care Networks for PD
Is Parkinson's Disease a Prion Disease?
Parkinson's Disease Linked to Gaucher's Disease
Brain Cells Keep Time Stamps: Implications for Parkinson's Disease Therapies
Is it Safe to Have an MRI with a DBS in Place?
Take Care of Your Bones as They Are Affected in Parkinson's Disease (Even in Men)
Is it Time to Start Paying Attention to Pain Symptoms in Parkinson's Disease Patients?
Glutathione Fails to Demonstrate Significant Improvement in PD Symptoms
Keeping an Eye on Trials Important to the Parkinson's Disease Patient
Increased Risk of Melanoma in Parkinson's Disease
Finally a DBS Expert Consensus Statement Aimed at Their True Customers: The Patients
Pesticides and Environmental Exposure in Parkinson's disease: Should We Stay Away From the Stink Truck?
Is Exercise Effective Treatment and Protection Against PD?
Why are Transplant Trials Struggling to Succeed in the Treatment of PD?
Are Monoamine Oxidase Inhibitors Disease Modifying or Neuroprotective in PD?
Update on Gene Therapy for Parkinson's Disease