Clinical factors associated with constipation in patients with Parkinson’s disease: a Brazilian cross-sectional study in Bahia

Background: Constipation is a well-known non-motor symptom that can occur during Parkinson’s disease (PD). However, there is still a lack of studies exploring the associations between constipation and other commonly observed characteristics of PD patients. Objective: Investigate clinical characteristics of Parkinson’s disease patients and their association with constipation at a reference center for movement disorders. Methods: Cross-sectional study carried out between 2023-2024, patients who reported defecating less than three times per week were classified as constipated. Clinical, social, and epidemiological data were collected, in addition to the application of the following scales: Unified Parkinsons Disease Rating Scale-Part III (UPDRS-III) for severity of motor symptoms, Beck Depression Inventory (BDI) for depression assessment, and the Hoehn and Yahr scale (HY) for functional disability. PD subtypes used were Tremor Dominant (TD), Akinetic-Rigid (AR), and Mixed, calculated using the UPDRS. Kolmogorov-Smirnov was performed to assess the normality of the data, Chi-square, Mann-Whitney, and T-test for correlation. Results: The study included 70 PD patients, of whom 67.1% were men, with a mean age of 65.45 (±9.28) years. Regarding clinical status, the mean disease duration was 9.60 (±5.16) years, and the severity of motor symptoms, as assessed by UPDRS III, had a mean score of 43.46 (±16.12). The median BDI score and Levodopa Equivalent Daily Dose (LEDD) were 13 (IQR: 4-20.75) and 1000 (IQR: 600-1460), respectively. Among all patients, 69 (98.6%) were using Levodopa and only 4 (5.7%) were using anticholinergics. The most frequent subtype was AR (45.7%), followed by TD (18.6%) and Mixed (8.6%). Constipation was identified in 19 (27.1%) patients, with a mean age of 66.9 (±8.5) years, and its presence was significantly associated with higher UPDRS III (p=0.026). Furthermore, the Mixed subtype was more associated with constipation than AR, while a negative association between TD and constipation was observed (p=0.001). There were no associations between constipation and disease duration LEDD, HY, or BDI (p>0.05). Conclusion: Constipation was found to be associated with more severe motor symptoms and Parkinson’s subtypes, particularly with the Mixed form, but no correlations were observed with other clinical factors. However, further studies are necessary to better understand this relationship.