{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T04:56:38Z","timestamp":1790398598207,"version":"4.1.0"},"reference-count":32,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2013,2,23]],"date-time":"2013-02-23T00:00:00Z","timestamp":1361577600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2013,8]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>Experimental studies support a link between stress and development of parkinsonian symptoms, but prospective population studies are lacking. The aim of the current study is to determine the effects of several psychosocial factors on the risk of <jats:styled-content style=\"fixed-case\">P<\/jats:styled-content>arkinson's disease (<jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>), as well as to identify potential pre\u2010motor symptoms for <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> in a large prospective cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In 1991\u20131993, a total of 9955 women and men free of <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> from the <jats:styled-content style=\"fixed-case\">C<\/jats:styled-content>openhagen City Heart Study were asked about major life events, economic hardship, social network, impaired sleep and vital exhaustion. The participants were followed for first\u2010time hospitalization with <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> in nationwide registers until 2011.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Vital exhaustion was associated with a higher risk of <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> hospitalization in an exposure\u2010dependent manner (<jats:italic>P<\/jats:italic><jats:sub>trend\u2005<\/jats:sub>=\u20050.001), with high vs. low vital exhaustion being associated with a hazard ratio of 2.50 [95% confidence interval (<jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>): 1.28\u20134.89]. A slightly higher risk of <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> hospitalization (<jats:styled-content style=\"fixed-case\">hazard ratio<\/jats:styled-content>\u00a0=\u00a01.49; 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>: 0.87\u20132.56) was suggested in participants with impaired sleep at baseline. No more than weak associations were observed for economic hardship, major life events or inadequate social network in the current study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Overall, the hypothesis that psychosocial risk factors affect the risk of <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content> is not supported. The results, however, suggest that vital exhaustion may be a pre\u2010motor marker of the neurodegenerative process eventually leading to motor symptoms and clinical <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>. Vital exhaustion may be useful for screening aimed at early detection and when considering disease\u2010modifying therapies in people at high risk of clinical <jats:styled-content style=\"fixed-case\">PD<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.12117","type":"journal-article","created":{"date-parts":[[2013,2,23]],"date-time":"2013-02-23T14:02:17Z","timestamp":1361628137000},"page":"1113-1120","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":28,"title":["Psychosocial risk factors, pre\u2010motor symptoms and first\u2010time hospitalization with <scp>P<\/scp>arkinson's disease: a prospective cohort study"],"prefix":"10.1111","volume":"20","author":[{"given":"A. 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