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In addition, we aimed to determine the impact of each autonomic domain on activities of daily living (ADLs) and health-related quality of life (HRQoL).<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>We enrolled 65 consecutive PD patients in a 5-year cohort study involving standardized evaluations of autonomic symptoms, orthostatic hypotension, and motor and non-motor features, including cognitive function. Associations were estimated as odds ratio and adjusted for PD duration, age, and baseline motor impairment.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Cardiovascular dysautonomia was associated with a sevenfold higher risk of developing dementia (95%CI: 1.154\u201350.436; <jats:italic>p<\/jats:italic>\u2009=\u20090.035) and a fivefold higher risk of falls (95%CI: 1.099\u201318.949; <jats:italic>p<\/jats:italic>\u2009=\u20090.039), as well as significantly higher impairment in ADLs (<jats:italic>p<\/jats:italic>\u2009=\u20090.042) and HRQoL (<jats:italic>p<\/jats:italic>\u2009=\u20090.031). No relevant associations were found between the other autonomic domains and these outcomes.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Cardiovascular dysautonomia, but not other domains, showed an association with worse 5-year clinical outcomes in PD. Our data suggest a specific role for cardiovascular autonomic dysregulation in the pathogenic mechanisms of PD progression.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1007\/s00415-022-11221-9","type":"journal-article","created":{"date-parts":[[2022,6,16]],"date-time":"2022-06-16T08:02:52Z","timestamp":1655366572000},"page":"5510-5520","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Differential impact of individual autonomic domains on clinical outcomes in Parkinson\u2019s disease"],"prefix":"10.1007","volume":"269","author":[{"given":"Katherine","family":"Longardner","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aristide","family":"Merola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Irene","family":"Litvan","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto Maria","family":"De Stefano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Simona","family":"Maule","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Fabrizio","family":"Vallelonga","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Leonardo","family":"Lopiano","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1312-1843","authenticated-orcid":false,"given":"Alberto","family":"Romagnolo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2022,6,16]]},"reference":[{"key":"11221_CR1","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1136\/jnnp-2017-316213","volume":"89","author":"T Simuni","year":"2018","unstructured":"Simuni T, Caspell-Garcia C, Coffey CS, Weintraub D, Mollenhauer B, Lasch S, Tanner CM, Jennings D, Kieburtz K, Chahine LM, Marek K (2018) Baseline prevalence and longitudinal evolution of non-motor symptoms in early Parkinson\u2019s disease: the PPMI cohort. 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Her research is supported in part by the NIH National Institute of Neurological Disorders and Stroke (Grant Number R21 NS114764-01A1). Dr. Merola: received speaker honoraria from Abbott and Boston Scientific, advisory board compensation from Abbott, Abbvie, Boston Scientific, and Lundbeck, and compensation as Chief Editor from Frontiers in Neurology Experimental Therapeutics. Dr. Litvan: Research is supported by the National Institutes of Health grants: 2R01AG038791-06A, U01NS100610, U01NS80818, R25NS098999; U19 AG063911-1 and 1R21NS114764-01A1; the Michael J Fox Foundation,\u00a0Parkinson Foundation, Lewy Body Association, CurePSP, Roche, Abbvie, Biogen, Centogene. EIP-Pharma, Biohaven Pharmaceuticals, Novartis, Brain Neurotherapy Bio and United Biopharma SRL\u2014UCB. She was a member of the Scientific Advisory Board of Lundbeck and is a Scientific advisor for Amydis and Rossy Center for Progressive Supranuclear Palsy University of Toronto. She receives her salary from the University of California San Diego and as Chief Editor of <i>Frontiers in Neurology.<\/i> Dr. Maria De Stefano: None. Dr. Maule: None. Dr. Vallelonga: None. Dr. Lopiano: received honoraria for lecturing and travel grants from Medtronic, UCB Pharma, and AbbVie. Dr. Romagnolo: received grant support and speaker honoraria from AbbVie, speaker honoraria from Bial and Chiesi Farmaceutici and travel grants from Lusofarmaco, Chiesi Farmaceutici, Medtronic, and UCB Pharma.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflicts of interest"}},{"value":"A. Romagnolo has full access to all the data in the study and takes responsibility for the integrity of the data, the accuracy of the data analysis, and the conduct of the research.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Data access and responsibility statement"}},{"value":"The authors declare that they acted in accordance with the ethical standards laid down in the 1964 Declaration of Helsinki. The local institutional review board approved the study and all participants provided written informed consent.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical standard"}}]}}