CONSTIPATION PRECEDING PARKINSON'S DISEASE–META-ANALYSIS

Constipation is a well-recognised non-motor feature of Parkinson9s disease (PD) and has been reported to predate PD in a number of observational studies, in some cases by over two decades. A systematic review and meta-analysis was carried out following MOOSE criteria. The literature search was undertaken on 7 December 2014 using PubMed and the relevant search terms ‘Parkinson9s disease’ and ‘Constipation’. Articles were screened for suitability and included if they met the specific criteria: observational studies with a cohort or case–control design; cases were patients with PD according to standard clinical criteria; controls were healthy or had no history of neurological disease; cohorts were representative of the general population; constipation in controls was assessed over the same time period as for patients; original data were reported. Data were extracted and combined using a fixed-effects model. Nine studies were included in the meta-analysis. Constipation was associated with an OR of 2.28 (95% confidence interval 2.10-2.46; p