Mediterranean diet adherence is related to reduced probability of prodromal Parkinson's disease

Mov Disord. 2019 Jan;34(1):48-57. doi: 10.1002/mds.27489. Epub 2018 Oct 10.


Background: The International Parkinson and Movement Disorder Society recently introduced a methodology for probability score calculation for prodromal PD.

Objectives: To assess the probability of prodromal PD in an older population and investigate its possible association with Mediterranean diet adherence.

Methods: Data from a population-based cohort study of older adults (HEllenic Longitudinal Investigation of Aging and Diet) in Greece were used. Probability of prodromal PD was calculated according to International Parkinson and Movement Disorder Society research criteria. A detailed food frequency questionnaire was used to evaluate dietary intake and calculate Mediterranean diet adherence score, ranging from 0 to 55, with higher scores indicating higher adherence.

Results: Median probability of prodromal PD was 1.9%, ranging from 0.2 to 96.7% in 1,731 PD-free individuals aged ≥ 65 (41% male). Lower probability for prodromal PD (P < 0.001) in the higher Mediterranean diet adherence groups was noted, driven mostly by nonmotor markers of prodromal PD, depression, constipation, urinary dysfunction, and daytime somnolence. Each unit increase in Mediterranean diet score was associated with a 2% decreased probability for prodromal PD (P < 0.001). Compared to participants in the lowest quartile of Mediterranean diet adherence, those in the highest quartile were associated with a ∼21% lower probability for prodromal PD.

Conclusions: Adherence to the Mediterranean diet is associated with lower probability of prodromal PD in older people. Further studies are needed to elucidate the potential causality of this association, potential relation of the Mediterranean diet to delayed onset or lower incidence of PD, as well as the underlying neurobiological mechanisms. © 2018 International Parkinson and Movement Disorder Society.

Keywords: Mediterranean; elderly; neurodegeneration; nutrition; prodromal.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Biomarkers / analysis
  • Cohort Studies
  • Constipation
  • Depression / etiology
  • Diet, Mediterranean*
  • Female
  • Greece
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Parkinson Disease / complications
  • Parkinson Disease / prevention & control*
  • Prodromal Symptoms
  • Treatment Adherence and Compliance


  • Biomarkers