CNR - Institute of Neuroscience CNR
Institute of Neuroscience


Modifiable risk factors for Parkinson's disease

Epidemiological studies suggest that environmental as well as lifestyle-related factors may be important for the development of Parkinson's disease (PD). The most consistent finding has been smoking and its inverse relationship to PD. Investigations into other risk factors have provided less consistent results, nevertheless some large studies have pointed out pesticide or herbicide exposures as putative risk factors.

Although there is increasing evidence that genetic factors may also play a role in the etiology of PD, this likely involves interaction with environmental factors. The relative contribution of genetic and environmental risk factors remains unknown.


This investigation was part of the ILSA, a multicenter community-based study of prevalence, incidence and determinants of major age-associated conditions of the elderly.

We investigated the association of major lifestyle-related risk factors with the prevalence of PD in a population-based perspective among the Italian elderly enrolled in a multicenter study, the ILSA (Italian Longitudinal Study on Aging).

Selected results

Distribution of risk factors under investigation among cases and non-cases. Crude and adjusted odds-ratios with 95% confidence intervals. The ILSA 1992.


Gender-specific multivariate analyses for the association between Parkinson's disease and selected risk factors. The ILSA, 1992.



The inverse association between cigarette smoking and PD proved significant only for heavy smoking in men. The overall non-significant result is not explained by a lack of power because the present study has one of the largest population-based sample ever published, but the unbalanced distribution of the exposure between men and women might account for this gender-related effect of smoking on the risk for PD.

The ILSA results cannot show that pesticides actually cause PD because of the cross-sectional study design. However, our data should suggest that herbicides/pesticides exposure represent one of the most eligible candidates for environmental factors involved in PD, even though only for men.

Our results are consistent with a multifactorial model of the disease.


  • Maggi S, Zucchetto M, Grigoletto F, Baldereschi M, Candelise L, Scarpini E, Scarlato G, Amaducci L (1994) The Italian Longitudinal Study on Aging (ILSA): design and methods. Aging (Milano) 6:464-73.
  • Baldereschi M, Di Carlo A, Vanni P, Ghetti A, Carbonin P, Amaducci L, Inzitari D, (2003) Lifestyle-related risk factors for Parkinson's disease: a population-based study. Acta Neurol. Scand. 108:239-44.
  • Baldereschi M, Di Carlo A, Rocca WA, Vanni P, Maggi S, Perissinotto E, Grigoletto F, Amaducci L, Inzitari D (2000) Parkinson's disease and parkinsonism in a longitudinal study: two-fold higher incidence in men. ILSA Working Group. Italian Longitudinal Study on Aging. Neurology 55:1358-63.


1991 - 1998: The ILSA was supported by the Italian National Research Council with annual grants to each research unit


  • Stefania Maggi
  • G. Scarlato, MD, L. Candelise, MD, E. Scarpini, University of Milan, Italy.
  • P. Carbonin, Università Cattolica del Sacro Cuore, Rome, Italy.
  • G. Farchi, MSc, E. Scafato, Istituto Superiore di Sanità, Rome, Italy.
  • F. Grigoletto, E. Perissinotto, L. Battistin, M. Bressan, G. Enzi, G. Bortolan, University of Padua, Italy.
  • C. Loeb, Italian National Research Council, Genoa, Italy.
  • C. Gandolfo, University of Genoa, Italy.
  • N. Canal, M. Franceschi, San Raffaele Institute, Milan, Italy.
  • A. Ghetti, R. Vergassola, Health Area 10, Florence, Italy.
  • L. Amaducci, D. Inzitari, University of Florence, Italy.
  • S. Bonaiuto, F. Fini, A. Vesprini, G. Cruciani, INRCA Fermo, Italy.
  • A. Capurso, P. Livrea, V. Lepore, University of Bari, Italy.
  • L. Motta, G. Carnazzo, P. Bentivegna, University of Catania, Italy.
  • F. Rengo, F. Covelluzzi, University of Naples, Italy.
  • P. Vanni, Department of Neurology, University of Florence, Italy.


PI photo

Antonio Salvatore Di Carlo

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Participating staff