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Neurology

Socioeconomic status and Parkinson’s disease in the Cardiovascular Health Study Mireya Long* Mireya Long John D. Beard Evan L. Thacker W. T. Longstreth Shu-Ching Hu Lana M. Chahine

Previous studies about the relationship between socioeconomic status (SES) and Parkinson’s disease (PD), a neurodegenerative disease, are few and produced conflicting results. In addition, most of these studies were limited by information bias, lacked prospective data, and lacked multiple measures of SES. The purpose of our study was to utilize the advantages of the Cardiovascular Health Study (CHS) to estimate associations between SES and PD in the US older adult population. CHS is a prospective cohort study of 5,888 adults, including 165 incident PD cases through 2006, from four US communities who were at least 63 years old at enrollment during 1989/90 and 1992/93. SES factors included education, occupation (lifetime and current), and income measured by survey at enrollment. Information on PD was ascertained using a variety of sources and final PD status was adjudicated by two movement disorders specialists. We used log-binomial regression models to estimate risk ratios (RR) and 95% confidence intervals (CI) to estimate associations between SES and PD adjusted for confounders. Compared to participants who worked in professional/technical/managerial/administrative occupations, participants who worked in sales/clerical service occupations had a RR of 1.69 (95% CI: 1.04, 2.77), and those who worked in craftsman/machine operator/laborer/farming/forestry occupations, a RR of 1.67 (95% CI: 1.02, 2.74) after adjusting for confounders. Participants who reported a total combined family income, before taxes, for the past 12 months of $5,000 – $7,999, compared to those who reported $16,000 – $24,999, had a RR of 2.08 (95% CI: 1.16, 3.76) after adjusting for confounders. No other SES factor was significantly associated with PD. We found that income and lifetime occupation may be related to incident PD in CHS. Our results should be confirmed by future studies that use larger samples and dates of PD diagnosis.