{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,4]],"date-time":"2026-04-04T13:27:15Z","timestamp":1775309235454,"version":"3.50.1"},"reference-count":53,"publisher":"Oxford University Press (OUP)","issue":"4","license":[{"start":{"date-parts":[[2026,3,10]],"date-time":"2026-03-10T00:00:00Z","timestamp":1773100800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University","award":["Z2024JC004"],"award-info":[{"award-number":["Z2024JC004"]}]},{"DOI":"10.13039\/501100001809","name":"National Natural Science Foundation of China","doi-asserted-by":"publisher","award":["82371430"],"award-info":[{"award-number":["82371430"]}],"id":[{"id":"10.13039\/501100001809","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,3,10]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Symptom-based indicators suggestive of autonomic dysfunction are common but underrecognized in Parkinson\u2019s disease (PD), with potential implications as a biomarker of aging for early detection and prognosis. We aimed to examine the associations between autonomic dysfunction and PD in a large, population-based cohort.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We analyzed 374\u2009657 UK Biobank participants who were free of PD at baseline. Autonomic symptoms\u2014including orthostatic hypotension, constipation, urinary and sexual dysfunction, hyperhidrosis, and other autonomic disorders\u2014were identified via hospital records. Incident PD and subsequent outcomes, including dementia and all-cause mortality, were tracked through June 2023. Cox models estimated hazard ratios for PD and adverse outcomes, and conditional logistic regression assessed the temporal trajectory of autonomic dysfunction relative to PD diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Over a median 14.1-year follow-up, 2568 participants developed PD. Orthostatic hypotension (HR: 2.91; 95% CI: 1.39-6.13), constipation (HR: 1.63; 95% CI: 1.19-2.24), urinary dysfunction (HR: 1.45; 95% CI: 1.04-2.02), and sexual dysfunction (HR: 3.56; 95% CI: 1.60-7.95) independently predicted PD risk. Prediagnostic and postdiagnostic autonomic dysfunction was associated with a higher risk of PD dementia and mortality. Autonomic dysfunction was detectable over 10\u2009years before PD diagnosis (OR: 4.46; 95% CI: 3.76-5.29), with the strongest association observed within 5\u2009years after PD onset (OR: 8.59; 95% CI: 7.58-9.74).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Symptom-based indicators suggestive of autonomic dysfunction serve as early clinical signals and robust prognostic markers in PD, highlighting their potential utility for early risk stratification and long-term patient management in large population-based settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/gerona\/glag077","type":"journal-article","created":{"date-parts":[[2026,3,21]],"date-time":"2026-03-21T10:23:32Z","timestamp":1774088612000},"source":"Crossref","is-referenced-by-count":0,"title":["Symptom-based indicators of autonomic dysfunction and their bidirectional associations with Parkinson\u2019s disease incidence and adverse outcomes"],"prefix":"10.1093","volume":"81","author":[{"given":"Tianmi","family":"Yang","sequence":"first","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu, Sichuan,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qianqian","family":"Wei","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu, Sichuan,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dejiang","family":"Pang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan 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Sichuan University , Chengdu, Sichuan,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu, Sichuan,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Qirui","family":"Jiang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu, Sichuan,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shichan","family":"Wang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu, Sichuan,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiyong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu, Sichuan,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sirui","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, Sichuan University , Chengdu, Sichuan,","place":["China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yuanzheng","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Neurology, Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, West China Hospital, 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