Risk of Parkinsons Disease in Stroke Survivors: A Nationwide Cohort Study in South Korea

BACKGROUNDPrevious studies have examined the risk of stroke in patients with Parkinsons disease (PD), but the incidence of PD onset among stroke survivors and its risk according to severity of post-stroke disabilities is scarcely investigated. This study aims to determine whether the risk of PD is increased among stroke survivors using a retrospective cohort with a large population-based database. METHODWe used data collected by the Korean National Health Insurance Service from 2010-2018 and examined 307,361 stroke survivors and 380,917 sex-and age-matched control subjects to uncover the incidence of PD. Cox proportional hazards regression was used to calculate the hazard ratio (HR) and 95% confidence interval (CI), and the risk of PD was compared according to presence and severity of disability. RESULTSDuring 4.31 years of follow-up, stroke survivors had a 1.67 times higher risk of PD compared to matched control subjects (adjusted HR, 1.67; 95% CI, 1.57-1.78). The risk of PD was greater among stroke survivors with disabilities than among those without disabilities, even after adjustment for multiple covariates (adjusted HR, 1.72; 95% CI, 1.55- 1.91 and adjusted HR, 1.66; 95% CI, 1.56-1.77, respectively). CONCLUSIONOur study demonstrated increased risk of PD onset among stroke survivors. Health professionals need to pay careful attention to detecting movement disorders as clues for diagnosing PD.