{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,10]],"date-time":"2026-08-10T06:28:49Z","timestamp":1786343329225,"version":"build-2736575974"},"reference-count":28,"publisher":"SAGE Publications","issue":"5","license":[{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T00:00:00Z","timestamp":1779667200000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Parkinson\u2019s Disease"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Observational evidence linking alcohol consumption to Parkinson's disease (PD) is inconsistent, potentially because conventional analyses do not account for the long latency between alcohol initiation and clinical onset or diagnosis.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To test whether latency-aware modeling changes alcohol\u2013PD associations and whether earlier initiation increases lifetime risk.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We applied a latency-explicit semi-Markov framework in two longitudinal, community-based screening cohorts in Taiwan. The Keelung cohort (Community A; n\u2009=\u200923,475; aged \u226560 years; 2002\u20132005) was used for model development, and the Changhua cohort (Community B; n\u2009=\u200990,129; aged \u226550 years; 2005\u20132022) was used for external application. We compared conventional logistic regression with latency-adjusted relative rates, conducted smoking-stratified analyses, and benchmarked age-specific projections against an independent door-to-door PD survey.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>In Community A, conventional regression suggested an inverse association (odds ratio 0.69; 95% confidence interval 0.53\u20130.91), whereas latency-adjusted modeling indicated higher PD risk among drinkers (relative rate 1.61; 95% confidence interval 1.32\u20131.95). Excess risk emerged \u223c25, \u223c35, and \u223c45 years after initiation at ages 20, 30, and 40 years, respectively; alcohol-attributable risk by age 90 was 32.1%, 20.7%, and 4.9%. Smoking shortened estimated latency by 5 years. In Community B, PD incidence was higher among drinkers than non-drinkers, with wider separation at older ages (70\u201374 years: 58.6 vs 46.0 per 100,000).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Accounting for exposure timing and latency reversed the apparent protective signal and supported a higher modeled lifetime PD risk with alcohol use, particularly earlier initiation. Incorporating latency may strengthen etiologic inference and inform long-horizon prevention strategies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Plain language summary title<\/jats:title>\n                    <jats:p>Because Parkinson\u2019s disease develops slowly, early drinking may matter later in life<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/1877718x261453796","type":"journal-article","created":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T12:28:31Z","timestamp":1779712111000},"page":"904-913","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Early alcohol initiation is associated with higher lifetime Parkinson's disease risk after accounting for exposure latency"],"prefix":"10.1177","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8651-2602","authenticated-orcid":false,"given":"Jung-Chen","family":"Chang","sequence":"first","affiliation":[{"name":"National Taiwan University"},{"name":"Department of Nursing, National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0628-8768","authenticated-orcid":false,"given":"Amy Ming-Fang","family":"Yen","sequence":"additional","affiliation":[{"name":"Taipei Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9750-3015","authenticated-orcid":false,"given":"Sam Li-Sheng","family":"Chen","sequence":"additional","affiliation":[{"name":"Taipei Medical University"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6537-5346","authenticated-orcid":false,"given":"Horng-Huei","family":"Liou","sequence":"additional","affiliation":[{"name":"Fu Jen Catholic University"},{"name":"Department of Neurology, Fu Jen Catholic University Hospital, Fu Jen Catholic University, New Taipei City, Taiwan"},{"name":"Department of Neurology and Pharmacology, College of Medicine, National Taiwan University and National Taiwan University Hospital, Taipei, Taiwan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5799-6705","authenticated-orcid":false,"given":"Tony Hsiu-Hsi","family":"Chen","sequence":"additional","affiliation":[{"name":"National Taiwan University"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,5,25]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199810083391506"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrdp.2017.13"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1002\/jnr.24592"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1002\/ana.23687"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.3390\/ijms21072316"},{"key":"e_1_3_3_7_2","first-page":"129","article-title":"Screening test for at-risk drinking in the elderly: abbreviated version of the alcohol use disorders identification test for the elderly population","volume":"14","author":"Lee JH","year":"2020","unstructured":"Lee JH, Choi YH. Screening test for at-risk drinking in the elderly: abbreviated version of the alcohol use disorders identification test for the elderly population. Int J Gerontol 2020; 14: 129\u2013133.","journal-title":"Int J Gerontol"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2377-13-190"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-93105-y"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28039"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1159\/000515030"},{"key":"e_1_3_3_12_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.25863"},{"key":"e_1_3_3_13_2","doi-asserted-by":"publisher","DOI":"10.3233\/JPD-223522"},{"key":"e_1_3_3_14_2","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27933"},{"key":"e_1_3_3_15_2","article-title":"Alcohol consumption, types of alcohol, and Parkinson\u2019s disease","volume":"8","author":"Liu R","year":"2013","unstructured":"Liu R, et al. Alcohol consumption, types of alcohol, and Parkinson\u2019s disease. 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