Clinical features and relative factors of constipation in a cohort of Chinese patients with Parkinson's disease

Table 1 Clinical characteristics of the subjects

Characteristic	Value	Characteristic	Value
Patients n	166	Hoehn-Yahr stage n (%)
Male n (%)	90 (54.22)	Stage 1	21 (12.7)
Mean age ± SD (yr)	65.92 ± 9.02	Stage 1.5	31 (18.7)
Hypertension n (%)	60 (36.14)	Stage 2	56 (33.7)
Diabetes n (%)	14 (8.43)	Stage 2.5	20 (12.0)
Coronary heart disease n (%)	16 (9.64)	Stage 3	28 (16.9)
Family history of PD n (%)	8 (4.82)	Stage 4	10 (6.0)
Mean age at onset ± SD (yr)	61.01 ± 9.97	Mean scores of scale ± SD
Disease duration (yr)	4.89 ± 3.93	UPDRS total	39.16 ± 18.39
Clinical type n (%)		UPDRS III	21.79 ± 11.72
Tremor	91 (54.82)	Wexner	4.29 ± 5.30
Non-tremor	75 (45.18)	HAMD	10.00 ± 8.61
Motor complications n (%)		HAMA	11.18 ± 10.27
Symptom fluctuation	51 (30.72)	MoCA	19.56 ± 5.75
Dyskinesia	25 (15.06)	PDQ-39	35.66 ± 24.06
Medication n (%)		NMSS	49.89 ± 32.55
Levodopa	134 (80.72)
Dopamine agonist	92 (55.42)
MAO-B inhibitor	44 (26.51)
COMT inhibitor	9 (5.42)
Anticholinergic	26 (15.66)
Amantadine	15 (9.04)

PD: Parkinson's disease; UPDRS: Unified Parkinson’s disease Rating Scale; HAMD: Hamilton depression scale; HAMA: Hamilton anxiety scale; MAO: Monoamine oxidase; COMT: Catechol-o-methyltransferase; NMSS: Non-motor symptoms assessment scales; PDQ-39: Parkinson’s disease questionnaire-39; MoCA: Montreal cognitive assessment.

Table 2 Comparison of general characteristics between the constipation and non-constipation groups

	Constipation	Non-constipation	t/χ2 value	P value
Male, n (%)	52 (59.77)	38 (48.10)	2.271	0.132
Mean age ± SD (yr)	68.10 ± 8.16	63.51 ± 9.42	3.355	0.001
Mean age at onset ± SD (yr)	62.34 ± 9.38	59.56 ± 10.52	1.796	0.074
Mean disease duration ± SD (yr)	5.66 ± 4.41	4.00 ± 3.12	2.732	0.007
Clinical types, n (%)
Tremor	46 (52.87)	45 (56.96)
Non-tremor	41 (47.13)	34 (43.04)	0.279	0.597
Hoehn-Yahr stage (median, quartile)	2.0 (1.5, 3.0)	2.0 (1.5, 2.5)	-2.451	0.014
Mean UPDRS total scores ± SD	43.02 ± 19.57	34.90 ± 16.05	2.889	0.004
Mean UPDRS III scores ± SD	23.94 ± 12.03	19.41 ± 10.97	2.512	0.013
Mean levodopa equivalent dose ± SD (mg/d)	468.17 ± 357.98	441.92 ± 428.78	0.416	0.678
Mean daily dose of levodopa ± SD (mg/d)	500.41 ± 326.55	430.91 ± 163.93	1.491	0.138
Mean levodopa medication times ± SD (mo)	53.43 ± 49.56	29.25 ± 35.77	3.265	0.001
Medication, n (%)
Levodopa	73 (83.91)	61 (77.22)	1.192	0.275
Dopamine agonist	53 (60.92)	39 (49.37)	2.273	0.135
MAO-B inhibitor	23 (26.44)	21 (26.58)	< 0.001	0.983
COMT inhibitor	7 (8.05)	2 (2.53)	2.455	0.117
Anticholinergic	14 (16.09)	12 (15.19)	0.026	0.873
Amantadine	7 (8.05)	8 (10.13)	0.218	0.641
Motor complications, n (%)
Symptom fluctuation	33 (37.93)	18 (22.78)	4.463	0.035
Dyskinesia	18 (20.69)	7 (8.86)	4.529	0.033
NMSS scores	61.05 ± 32.95	37.59 ± 27.42	4.928	0.000
HAMD scores	11.94 ± 8.59	7.86 ± 8.16	3.113	0.002
HAMA scores	13.20 ± 10.37	8.96 ± 9.75	2.688	0.008
MoCA scores	19.71 ± 5.48	19.36 ± 6.11	0.374	0.709
PDQ-39 scores	41.07 ± 25.58	29.69 ± 20.84	3.104	0.002

UPDRS: Unified Parkinson’s disease Rating Scale; MAO: Monoamine oxidase; COMT: Catechol-o-methyltransferase; NMSS: Non-motor symptoms assessment Scales; HAMD: Hamilton depression scale; HAMA: Hamilton anxiety scale; MoCA: Montreal cognitive assessment; PDQ-39: Parkinson’s disease questionnaire-39.

Table 3 Incidence of depression, anxiety, and cognitive impairment between the constipation and non-constipation groups

	n	Anxiety (%)	Depression (%)	Cognitive impairment (%)
Constipation	87	55 (63.22)	56 (64.37)	71 (81.61)
Non-constipation	79	40 (50.63)	37 (46.84)	63 (79.75)
χ2		2.695	5.187	0.092
P		0.115	0.029	0.845

Table 4 Comparison of incidence and severity of constipation in different modified Hoehn-Yahr grades (%, ± s)

Grade	1-1.5	2-2.5	3	4	χ2/F	P value
n	52	76	28	10
Constipation	22 (42.31)	41 (53.95)	16 (57.14)	8 (80.00)	5.470	0.140
Wexner score	6.73 ± 4.14	6.76 ± 3.58	11.19 ± 5.38	13.50 ± 2.98	10.138	< 0.001

Table 5 Correlations of constipation and different related scale scores

	r	P value
Age	0.255	0.001
Modified Hoehn-Yahr stage	0.172	0.027
NMMS scores	0.361	< 0.001
UPDRS III scores	0.194	0.013
UPDRS total scores	0.221	0.004
PDQ-39 scores	0.237	0.002
HAMD scores	0.238	0.002
HAMA scores	0.207	0.008

NMSS: Non-motor symptoms assessment scales; UPDRS: Unified Parkinson’s disease Rating Scale; PDQ-39: Parkinson’s disease questionnaire-39; HAMD: Hamilton depression scale; HAMA: Hamilton anxiety scale.