To determine the frequency and time of onset of constipation in patients with Early-Onset Parkinson’s Disease (EOPD) and to explore the association between constipation and mortality.

Constipation is a frequent non-motor symptom in Parkinson disease (PD), affecting up to 80% of patients. However, little is known about the frequency of constipation in EOPD.

We included all patients with a PD motor symptom onset before the age of 50 (EOPD) that presented to the Mayo Clinic Health System from 1991 to 2010. A movement disorder specialist reviewed their medical records to confirm the clinical diagnosis of EOPD. The presence and time of onset of constipation was reported through a systematic review of patients’ medical records.  We excluded secondary causes of constipation (drug induced or post-surgical). A Cox proportional-hazard regression was used to assess the association between constipation and patient mortality. Models were adjusted for patients’ sex and age at motor onset.

827 patients were included. The median age at motor symptom onset was 42 years. 65 patients had died at the time of data collection. Constipation was present in 392 (47.4%) patients. In 95.4% of patients, constipation occurred following motor symptom onset. The median time from motor symptom onset to constipation was 6 years. The presence of constipation was associated with a higher risk of mortality (HR 5.13, p<0.001). In an adjusted analysis patients’ age and sex, constipation was associated with a four-fold increase in mortality rate (HR 4.35, p < 0.001).

Constipation affects nearly half of EOPD patients from our clinical cohort. It developed post-motor-symptom-onset in 95.4% of patients. Constipation was associated with a four-fold increase in mortality in this EOPD population. Our findings contrast with our previous study on Late-Onset PD in Olmsted-County, Minnesota, where we reported constipation in 50% of patients, without an increased risk of mortality.