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Published in: BMC Neurology 1/2024

Open Access 01-12-2024 | Parkinson's Disease | Research

Association of time spent outdoors with the risk of Parkinson’s disease: a prospective cohort study of 329,359 participants

Authors: Ling Hu, Yisen Shi, Xinyang Zou, Zhaohui Lai, Fabin Lin, Guoen Cai, Xianghong Liu

Published in: BMC Neurology | Issue 1/2024

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Abstract

Background

Studies on the association between time spent outdoors and the development of Parkinson’s disease (PD) are lacking, and whether this relationship differs in different subgroups (age, sex) remains unclear.

Objective

We here examined the association between time spent outdoors and the incidence of PD in different seasons.

Methods

This study included 329,359 participants from the UK Biobank. Data regarding hours spent outdoors during a typical day were obtained through questionnaires. Cox proportional hazard regression models were used to estimate hazard ratios (HRs) for the association between exposure to outdoors duration and PD incidence. Restricted cubic spline was used to explore the potential nonlinear relationship between time spent outdoors and PD risk. To explore the potential mechanisms of time spent outdoors effecting the risk of PD incidence, their association with serum vitamin D was further analysed separately.

Results

During a median follow-up of 13.57 years, 2,238 participants developed PD. In summer, time spent outdoors > 5.0 h/day was associated with a reduced PD risk compared with ≤ 2.0 h/day (HR = 0.84, 95% CI, 0.74–0.95). In winter too, time spent outdoors > 2.0 h/day was also associated with a reduced PD risk compared with ≤ 1.0 h/day (HR = 0.85, 95% CI, 0.76–0.94). For annual average time spent outdoors, participants who went outdoors for more than 3.5 h/day had a reduced PD risk than those who went outdoors for ≤ 1.5 h/day (HR = 0.85, 95% CI, 0.75–0.96). Additionally, sex and age differences were observed in the association between time spent outdoors and the PD risk. Moreover, Time spent outdoors was observed to be positively associated with serum vitamin D levels. Compared with serum vitamin D-deficient participants, the risk of PD was reduced by 15% in the sufficient participants.

Conclusion

In the total population, higher time spent outdoors was linked to a reduced PD risk. However, this association may vary among different age or sex groups.
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Literature
1.
go back to reference Global regional, national burden of neurological disorders. During 1990–2015: a systematic analysis for the global burden of Disease Study 2015. Lancet Neurol. 2017;16(11):877–97.CrossRef Global regional, national burden of neurological disorders. During 1990–2015: a systematic analysis for the global burden of Disease Study 2015. Lancet Neurol. 2017;16(11):877–97.CrossRef
3.
go back to reference Ascherio A, Schwarzschild MA. The epidemiology of Parkinson’s Disease: risk factors and prevention. Lancet Neurol. 2016;15(12):1257–72.CrossRefPubMed Ascherio A, Schwarzschild MA. The epidemiology of Parkinson’s Disease: risk factors and prevention. Lancet Neurol. 2016;15(12):1257–72.CrossRefPubMed
4.
go back to reference Al-Kuraishy HM, Al-Gareeb AI, Selim HM, Alexiou A, Papadakis M, Negm WA, Batiha GE. Does vitamin D protect or treat Parkinson’s disease? A narrative review. Naunyn Schmiedebergs Arch Pharmacol. 2023. Al-Kuraishy HM, Al-Gareeb AI, Selim HM, Alexiou A, Papadakis M, Negm WA, Batiha GE. Does vitamin D protect or treat Parkinson’s disease? A narrative review. Naunyn Schmiedebergs Arch Pharmacol. 2023.
5.
6.
go back to reference Zhu D, Liu GY, Lv Z, Wen SR, Bi S, Wang WZ. Inverse associations of outdoor activity and vitamin D intake with the risk of Parkinson’s Disease. J Zhejiang Univ Sci B. 2014;15(10):923–7.CrossRefPubMedPubMedCentral Zhu D, Liu GY, Lv Z, Wen SR, Bi S, Wang WZ. Inverse associations of outdoor activity and vitamin D intake with the risk of Parkinson’s Disease. J Zhejiang Univ Sci B. 2014;15(10):923–7.CrossRefPubMedPubMedCentral
7.
go back to reference Kenborg L, Lassen CF, Ritz B, Schernhammer ES, Hansen J, Gatto NM, Olsen JH. Outdoor work and risk for Parkinson’s Disease: a population-based case-control study. Occup Environ Med. 2011;68(4):273–8.CrossRefPubMed Kenborg L, Lassen CF, Ritz B, Schernhammer ES, Hansen J, Gatto NM, Olsen JH. Outdoor work and risk for Parkinson’s Disease: a population-based case-control study. Occup Environ Med. 2011;68(4):273–8.CrossRefPubMed
8.
go back to reference Kwon E, Gallagher LG, Searles Nielsen S, Franklin GM, Littell CT, Longstreth WT Jr., Swanson PD, Checkoway H. Parkinson’s Disease and history of outdoor occupation. Parkinsonism Relat Disord. 2013;19(12):1164–6.CrossRefPubMedPubMedCentral Kwon E, Gallagher LG, Searles Nielsen S, Franklin GM, Littell CT, Longstreth WT Jr., Swanson PD, Checkoway H. Parkinson’s Disease and history of outdoor occupation. Parkinsonism Relat Disord. 2013;19(12):1164–6.CrossRefPubMedPubMedCentral
9.
go back to reference Zhou Z, Zhou R, Zhang Z, Li K. The Association between Vitamin D Status, vitamin D supplementation, sunlight exposure, and Parkinson’s Disease: a systematic review and Meta-analysis. Med Sci Monit. 2019;25:666–74.CrossRefPubMedPubMedCentral Zhou Z, Zhou R, Zhang Z, Li K. The Association between Vitamin D Status, vitamin D supplementation, sunlight exposure, and Parkinson’s Disease: a systematic review and Meta-analysis. Med Sci Monit. 2019;25:666–74.CrossRefPubMedPubMedCentral
11.
12.
go back to reference Okan F, Zincir H, Deveci K. The Effect of Sun Light exposure to the level of vitamin D in Elderly people living in nursing home. J Clin Densitom. 2022;25(2):261–71.CrossRefPubMed Okan F, Zincir H, Deveci K. The Effect of Sun Light exposure to the level of vitamin D in Elderly people living in nursing home. J Clin Densitom. 2022;25(2):261–71.CrossRefPubMed
13.
go back to reference Ding H, Dhima K, Lockhart KC, Locascio JJ, Hoesing AN, Duong K, Trisini-Lipsanopoulos A, Hayes MT, Sohur US, Wills AM, et al. Unrecognized vitamin D3 deficiency is common in Parkinson Disease: Harvard Biomarker Study. Neurology. 2013;81(17):1531–7.CrossRefPubMedPubMedCentral Ding H, Dhima K, Lockhart KC, Locascio JJ, Hoesing AN, Duong K, Trisini-Lipsanopoulos A, Hayes MT, Sohur US, Wills AM, et al. Unrecognized vitamin D3 deficiency is common in Parkinson Disease: Harvard Biomarker Study. Neurology. 2013;81(17):1531–7.CrossRefPubMedPubMedCentral
14.
go back to reference Lv Z, Qi H, Wang L, Fan X, Han F, Wang H, Bi S. Vitamin D status and Parkinson’s Disease: a systematic review and meta-analysis. Neurol Sci. 2014;35(11):1723–30.CrossRefPubMed Lv Z, Qi H, Wang L, Fan X, Han F, Wang H, Bi S. Vitamin D status and Parkinson’s Disease: a systematic review and meta-analysis. Neurol Sci. 2014;35(11):1723–30.CrossRefPubMed
15.
go back to reference Barichella M, Cereda E, Iorio L, Pinelli G, Ferri V, Cassani E, Bolliri C, Caronni S, Pusani C, Schiaffino MG, et al. Clinical correlates of serum 25-hydroxyvitamin D in Parkinson’s Disease. Nutr Neurosci. 2022;25(6):1128–36.CrossRefPubMed Barichella M, Cereda E, Iorio L, Pinelli G, Ferri V, Cassani E, Bolliri C, Caronni S, Pusani C, Schiaffino MG, et al. Clinical correlates of serum 25-hydroxyvitamin D in Parkinson’s Disease. Nutr Neurosci. 2022;25(6):1128–36.CrossRefPubMed
16.
go back to reference Ma LZ, Ma YH, Ou YN, Chen SD, Yang L, Dong Q, Cheng W, Tan L, Yu JT. Time spent in outdoor light is associated with the risk of Dementia: a prospective cohort study of 362094 participants. BMC Med. 2022;20(1):132.CrossRefPubMedPubMedCentral Ma LZ, Ma YH, Ou YN, Chen SD, Yang L, Dong Q, Cheng W, Tan L, Yu JT. Time spent in outdoor light is associated with the risk of Dementia: a prospective cohort study of 362094 participants. BMC Med. 2022;20(1):132.CrossRefPubMedPubMedCentral
17.
go back to reference Lin J, Yang H, Zhang Y, Zhou L, Chen Y, Xu W, Wang Y. Association of time spent in outdoor light and genetic susceptibility with the risk of type 2 Diabetes. Sci Total Environ. 2023;888:164253.CrossRefPubMed Lin J, Yang H, Zhang Y, Zhou L, Chen Y, Xu W, Wang Y. Association of time spent in outdoor light and genetic susceptibility with the risk of type 2 Diabetes. Sci Total Environ. 2023;888:164253.CrossRefPubMed
19.
go back to reference Zheng Z, Lv Y, Rong S, Sun T, Chen L. Physical Frailty, genetic predisposition, and Incident Parkinson Disease. JAMA Neurol. 2023. Zheng Z, Lv Y, Rong S, Sun T, Chen L. Physical Frailty, genetic predisposition, and Incident Parkinson Disease. JAMA Neurol. 2023.
20.
go back to reference Shen L, Ji HF. Associations between vitamin D status, supplementation, Outdoor Work and Risk of Parkinson’s Disease: a Meta-Analysis Assessment. Nutrients. 2015;7(6):4817–27.CrossRefPubMedPubMedCentral Shen L, Ji HF. Associations between vitamin D status, supplementation, Outdoor Work and Risk of Parkinson’s Disease: a Meta-Analysis Assessment. Nutrients. 2015;7(6):4817–27.CrossRefPubMedPubMedCentral
21.
go back to reference Kravietz A, Kab S, Wald L, Dugravot A, Singh-Manoux A, Moisan F, Elbaz A. Association of UV radiation with Parkinson Disease incidence: a nationwide French ecologic study. Environ Res. 2017;154:50–6.CrossRefPubMed Kravietz A, Kab S, Wald L, Dugravot A, Singh-Manoux A, Moisan F, Elbaz A. Association of UV radiation with Parkinson Disease incidence: a nationwide French ecologic study. Environ Res. 2017;154:50–6.CrossRefPubMed
22.
go back to reference Kelly D, Theodoratou E, Farrington SM, Fraser R, Campbell H, Dunlop MG, Zgaga L. The contributions of adjusted ambient ultraviolet B radiation at place of residence and other determinants to serum 25-hydroxyvitamin D concentrations. Br J Dermatol. 2016;174(5):1068–78.CrossRefPubMed Kelly D, Theodoratou E, Farrington SM, Fraser R, Campbell H, Dunlop MG, Zgaga L. The contributions of adjusted ambient ultraviolet B radiation at place of residence and other determinants to serum 25-hydroxyvitamin D concentrations. Br J Dermatol. 2016;174(5):1068–78.CrossRefPubMed
23.
go back to reference O’Sullivan F, Laird E, Kelly D, van Geffen J, van Weele M, McNulty H, Hoey L, Healy M, McCarroll K, Cunningham C, et al. Ambient UVB dose and Sun Enjoyment are important predictors of vitamin D status in an older Population. J Nutr. 2017;147(5):858–68.CrossRefPubMed O’Sullivan F, Laird E, Kelly D, van Geffen J, van Weele M, McNulty H, Hoey L, Healy M, McCarroll K, Cunningham C, et al. Ambient UVB dose and Sun Enjoyment are important predictors of vitamin D status in an older Population. J Nutr. 2017;147(5):858–68.CrossRefPubMed
24.
go back to reference Farrar MD, Webb AR, Kift R, Durkin MT, Allan D, Herbert A, Berry JL, Rhodes LE. Efficacy of a dose range of simulated sunlight exposures in raising vitamin D status in south Asian adults: implications for targeted guidance on sun exposure. Am J Clin Nutr. 2013;97(6):1210–6.CrossRefPubMed Farrar MD, Webb AR, Kift R, Durkin MT, Allan D, Herbert A, Berry JL, Rhodes LE. Efficacy of a dose range of simulated sunlight exposures in raising vitamin D status in south Asian adults: implications for targeted guidance on sun exposure. Am J Clin Nutr. 2013;97(6):1210–6.CrossRefPubMed
25.
go back to reference Knekt P, Kilkkinen A, Rissanen H, Marniemi J, Sääksjärvi K, Heliövaara M. Serum vitamin D and the risk of Parkinson Disease. Arch Neurol. 2010;67(7):808–11.CrossRefPubMedPubMedCentral Knekt P, Kilkkinen A, Rissanen H, Marniemi J, Sääksjärvi K, Heliövaara M. Serum vitamin D and the risk of Parkinson Disease. Arch Neurol. 2010;67(7):808–11.CrossRefPubMedPubMedCentral
26.
go back to reference Suzuki M, Yoshioka M, Hashimoto M, Murakami M, Kawasaki K, Noya M, Takahashi D, Urashima M. 25-hydroxyvitamin D, vitamin D receptor gene polymorphisms, and severity of Parkinson’s Disease. Mov Disord. 2012;27(2):264–71.CrossRefPubMed Suzuki M, Yoshioka M, Hashimoto M, Murakami M, Kawasaki K, Noya M, Takahashi D, Urashima M. 25-hydroxyvitamin D, vitamin D receptor gene polymorphisms, and severity of Parkinson’s Disease. Mov Disord. 2012;27(2):264–71.CrossRefPubMed
27.
go back to reference The Unified Parkinson’s Disease Rating Scale. (UPDRS): status and recommendations. Mov Disord. 2003;18(7):738–50. The Unified Parkinson’s Disease Rating Scale. (UPDRS): status and recommendations. Mov Disord. 2003;18(7):738–50.
28.
29.
go back to reference Burns AC, Saxena R, Vetter C, Phillips AJK, Lane JM, Cain SW. Time spent in outdoor light is associated with mood, sleep, and circadian rhythm-related outcomes: a cross-sectional and longitudinal study in over 400,000 UK Biobank participants. J Affect Disord. 2021;295:347–52.CrossRefPubMedPubMedCentral Burns AC, Saxena R, Vetter C, Phillips AJK, Lane JM, Cain SW. Time spent in outdoor light is associated with mood, sleep, and circadian rhythm-related outcomes: a cross-sectional and longitudinal study in over 400,000 UK Biobank participants. J Affect Disord. 2021;295:347–52.CrossRefPubMedPubMedCentral
30.
go back to reference Lysen TS, Darweesh SKL, Ikram MK, Luik AI, Ikram MA. Sleep and risk of parkinsonism and Parkinson’s Disease: a population-based study. Brain. 2019;142(7):2013–22.CrossRefPubMedPubMedCentral Lysen TS, Darweesh SKL, Ikram MK, Luik AI, Ikram MA. Sleep and risk of parkinsonism and Parkinson’s Disease: a population-based study. Brain. 2019;142(7):2013–22.CrossRefPubMedPubMedCentral
31.
go back to reference Tancredi S, Urbano T, Vinceti M, Filippini T. Artificial light at night and risk of mental disorders: a systematic review. Sci Total Environ. 2022;833:155185.CrossRefPubMed Tancredi S, Urbano T, Vinceti M, Filippini T. Artificial light at night and risk of mental disorders: a systematic review. Sci Total Environ. 2022;833:155185.CrossRefPubMed
32.
go back to reference Urbano T, Vinceti M, Wise LA, Filippini T. Light at night and risk of Breast cancer: a systematic review and dose-response meta-analysis. Int J Health Geogr. 2021;20(1):44.CrossRefPubMedPubMedCentral Urbano T, Vinceti M, Wise LA, Filippini T. Light at night and risk of Breast cancer: a systematic review and dose-response meta-analysis. Int J Health Geogr. 2021;20(1):44.CrossRefPubMedPubMedCentral
33.
go back to reference Fasciani I, Petragnano F, Aloisi G, Marampon F, Rossi M, Coppolino MF, Rossi R, Longoni B, Scarselli M, Maggio R. A new threat to dopamine neurons: the Downside of Artificial Light. Neuroscience. 2020;432:216–28.CrossRefPubMed Fasciani I, Petragnano F, Aloisi G, Marampon F, Rossi M, Coppolino MF, Rossi R, Longoni B, Scarselli M, Maggio R. A new threat to dopamine neurons: the Downside of Artificial Light. Neuroscience. 2020;432:216–28.CrossRefPubMed
34.
go back to reference Qian Y, Fu X, Zhang H, Yang Y, Wang G. Comparative efficacy of 24 exercise types on postural instability in adults with Parkinson’s Disease: a systematic review and network meta-analysis. BMC Geriatr. 2023;23(1):522.CrossRefPubMedPubMedCentral Qian Y, Fu X, Zhang H, Yang Y, Wang G. Comparative efficacy of 24 exercise types on postural instability in adults with Parkinson’s Disease: a systematic review and network meta-analysis. BMC Geriatr. 2023;23(1):522.CrossRefPubMedPubMedCentral
35.
go back to reference Petzinger GM, Fisher BE, McEwen S, Beeler JA, Walsh JP, Jakowec MW. Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson’s Disease. Lancet Neurol. 2013;12(7):716–26.CrossRefPubMedPubMedCentral Petzinger GM, Fisher BE, McEwen S, Beeler JA, Walsh JP, Jakowec MW. Exercise-enhanced neuroplasticity targeting motor and cognitive circuitry in Parkinson’s Disease. Lancet Neurol. 2013;12(7):716–26.CrossRefPubMedPubMedCentral
36.
go back to reference Raimondi S, Suppa M, Gandini S. Melanoma Epidemiology and Sun Exposure. Acta Derm Venereol. 2020;100(11):adv00136.CrossRefPubMed Raimondi S, Suppa M, Gandini S. Melanoma Epidemiology and Sun Exposure. Acta Derm Venereol. 2020;100(11):adv00136.CrossRefPubMed
37.
go back to reference Vashist P, Tandon R, Murthy GVS, Barua CK, Deka D, Singh S, Gupta V, Gupta N, Wadhwani M, Singh R, et al. Association of cataract and sun exposure in geographically diverse populations of India: the CASE study. First Report of the ICMR-EYE SEE Study Group. PLoS ONE. 2020;15(1):e0227868.CrossRefPubMedPubMedCentral Vashist P, Tandon R, Murthy GVS, Barua CK, Deka D, Singh S, Gupta V, Gupta N, Wadhwani M, Singh R, et al. Association of cataract and sun exposure in geographically diverse populations of India: the CASE study. First Report of the ICMR-EYE SEE Study Group. PLoS ONE. 2020;15(1):e0227868.CrossRefPubMedPubMedCentral
38.
go back to reference Dean DN, Lee JC. Linking Parkinson’s Disease and Melanoma: interplay between α-Synuclein and Pmel17 amyloid formation. Mov Disord. 2021;36(7):1489–98.CrossRefPubMedPubMedCentral Dean DN, Lee JC. Linking Parkinson’s Disease and Melanoma: interplay between α-Synuclein and Pmel17 amyloid formation. Mov Disord. 2021;36(7):1489–98.CrossRefPubMedPubMedCentral
39.
go back to reference Lai SW, Lin CL, Liao KF, Chang-Ou KC. Increased risk of Parkinson’s Disease in cataract patients: a population-based cohort study. Parkinsonism Relat Disord. 2015;21(1):68–71.CrossRefPubMed Lai SW, Lin CL, Liao KF, Chang-Ou KC. Increased risk of Parkinson’s Disease in cataract patients: a population-based cohort study. Parkinsonism Relat Disord. 2015;21(1):68–71.CrossRefPubMed
Metadata
Title
Association of time spent outdoors with the risk of Parkinson’s disease: a prospective cohort study of 329,359 participants
Authors
Ling Hu
Yisen Shi
Xinyang Zou
Zhaohui Lai
Fabin Lin
Guoen Cai
Xianghong Liu
Publication date
01-12-2024
Publisher
BioMed Central
Published in
BMC Neurology / Issue 1/2024
Electronic ISSN: 1471-2377
DOI
https://doi.org/10.1186/s12883-023-03499-7

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