{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,21]],"date-time":"2026-05-21T14:40:04Z","timestamp":1779374404828,"version":"3.53.1"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"10","license":[{"start":{"date-parts":[[2023,10,2]],"date-time":"2023-10-02T00:00:00Z","timestamp":1696204800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"VHS Medical Center Research Grant","award":["VHSMC21045"],"award-info":[{"award-number":["VHSMC21045"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,10,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>Vietnam-era veterans were exposed to Agent Orange (AO), which is associated with a high prevalence of Parkinson\u2019s disease (PD). However, little is known about the development of PD-like symptoms caused by drug-induced parkinsonism (DIP) in such populations. This study aimed to investigate PD incidence and PD risk following exposure to AO or DIP-risk drugs in veterans.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>A retrospective cohort study was conducted using 12\u00a0years (2009\u20132020) of electronic medical records of the Veterans Health Service Medical Center, the largest Veterans Affairs hospital in South Korea (n\u2009=\u200937,246; 100% male; age, 65.57\u2009\u00b1\u20098.12\u00a0years). Exposure to AO or DIP-risk drugs, including antipsychotic, prokinetic, anti-epileptic, dopamine-depleting and anti-anginal agents, was assessed in veterans with PD, operationally defined as having a PD diagnosis and one or more prescriptions for PD treatment. The PD risk was calculated using multiple logistic regression analysis adjusted for age and comorbidities.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>The rates of DIP-risk drug use and AO exposure were 37.92% and 62.62%, respectively. The PD incidence from 2010 to 2020 was 3.08%; 1.30% with neither exposure, 1.63% with AO exposure, 4.38% with DIP-risk drug use, and 6.33% with both. Combined exposure to AO and DIP-risk drugs increased the PD risk (adjusted odds ratio\u2009=\u20091.68, 95% confidence interval, 1.36\u20132.08, P\u2009&amp;lt;\u20090.001).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>The PD incidence was 1.31 times higher with AO exposure alone and 1.68 times higher with AO exposure and DIP-risk drug use. The results suggest the necessity for careful monitoring and DIP-risk drug prescription in patients with AO exposure.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afad192","type":"journal-article","created":{"date-parts":[[2023,10,27]],"date-time":"2023-10-27T22:26:50Z","timestamp":1698445610000},"source":"Crossref","is-referenced-by-count":6,"title":["Effects of defoliant exposure and medication use on the development of Parkinson\u2019s disease in veterans"],"prefix":"10.1093","volume":"52","author":[{"given":"Seulki","family":"Song","sequence":"first","affiliation":[{"name":"College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University , Seoul , Republic of Korea"},{"name":"Department of Pharmacy, Veterans Health Service Medical Center , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jun Y","family":"Kim","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation, Hanyang University Medical Center , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Young","family":"Lee","sequence":"additional","affiliation":[{"name":"Veterans Medical Research Institute, Veterans Health Service Medical Center , Seoul , Republic of Korea"},{"name":"Department of Applied Statistics, Chung-Ang University , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyokeun","family":"Jeong","sequence":"additional","affiliation":[{"name":"Department of Pharmacy, Veterans Health Service Medical Center , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Seungyeon","family":"Kim","sequence":"additional","affiliation":[{"name":"College of Pharmacy, Dankook University , Cheonan , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eunkyung E","family":"Lee","sequence":"additional","affiliation":[{"name":"College of Pharmacy & Research Institute of Pharmaceutical Sciences, Seoul National University , Seoul , Republic of Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2023,10,26]]},"reference":[{"key":"2023102721152102900_ref1","doi-asserted-by":"crossref","first-page":"75","DOI":"10.12779\/dnd.2016.15.3.75","article-title":"Is Parkinson\u2019s disease with history of agent Orange exposure different from idiopathic Parkinson\u2019s disease?","volume":"15","author":"Yang","year":"2016","journal-title":"Dement Neurocogn Disord"},{"key":"2023102721152102900_ref2","doi-asserted-by":"crossref","first-page":"1825","DOI":"10.1093\/ije\/dyu183","article-title":"Agent Orange exposure and risk of death in Korean Vietnam veterans: Korean veterans health study","volume":"43","author":"Yi","year":"2014","journal-title":"Int J Epidemiol"},{"key":"2023102721152102900_ref3","first-page":"2018","volume-title":"Veterans and Agent Orange: Update 11","author":"National Academies of Sciences, Engineering, and Medicine, Health and Medicine Division, Board on Population Health and Public Health Practice, Committee to Review the Health Effects in Vietnam Veterans of Exposure to Herbicides (Eleventh Biennial Update)","year":"2018"},{"key":"2023102721152102900_ref4","doi-asserted-by":"crossref","DOI":"10.1016\/j.worlddev.2022.105813","article-title":"The long-term health impact of agent Orange: evidence from the Vietnam war","volume":"155","author":"Le","year":"2022","journal-title":"World Dev"},{"key":"2023102721152102900_ref5","doi-asserted-by":"crossref","first-page":"56","DOI":"10.1016\/j.envres.2014.04.027","article-title":"Agent Orange exposure and disease prevalence in Korean Vietnam veterans: the Korean veterans health study","volume":"133","author":"Yi","year":"2014","journal-title":"Environ Res"},{"key":"2023102721152102900_ref6","first-page":"S18","article-title":"Early and accurate identification of Parkinson disease among US veterans","volume":"36","author":"Mantri","year":"2019","journal-title":"Fed Pract"},{"key":"2023102721152102900_ref7","volume-title":"Blue Water Navy Vietnam Veterans and Agent Orange Exposure","author":"Committee on Blue Water Navy Vietnam Veterans and Agent Orange Exposure","year":"2011"},{"key":"2023102721152102900_ref8","first-page":"4173","article-title":"Diseases associated with exposure to contaminants in the water supply at camp Lejeune. 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