Supplementary Material for: Association of a Healthy Lifestyle with Risk of Parkinson’s Disease and Genetic Predisposition

Background: Parkinson’s disease (PD) is the second most common neurodegenerative disease with largely unknown etiology. Evaluating the association between a healthy lifestyle with PD and genetic risk is necessary.
Methods: The study included 438,241 participants from UK Biobank, with lifestyle information collected via baseline questionnaires. Polygenic risk scores (PRS) were divided into quartiles. The healthy lifestyle, including alcohol consumption, BMI, physical activity, sleep duration, sedentary time, social connections, and diet, was categorized into favorable (scoring 6-7), intermediate (scoring 4-5), and unfavorable (scoring≤3) lifestyles.
Results: During an average follow-up of 9.34 years, 2,996 cases were diagnosed with PD. Compared to participants with an unfavorable lifestyle, those with a favorable lifestyle had a significantly lower risk (HR 0.862, 95% CI 0.753-0.986). Regular physical activity, adequate sleep, and appropriate social connection were protective factors for the risk of PD (HR 0.839, 95% CI 0.779-0.905; HR 0.921, 95% CI 0.851- 0.997; HR 0.790, 95% CI 0.698-0.893). Subgroup analysis by PRS showed that adhering to a healthy lifestyle reduced the risk of PD in all subgroups except the low genetic risk (HR 0.673, 95% CI 0.510-0.889; HR 0.774, 95% CI 0.611-0.982; HR 0.769, 95% CI 0.633-0.935). There was an interaction between high genetic risk and lifestyle scores and sleep duration (P=0.015 and P=0.024, respectively), also between sex and sedentary time (P=0.002).
Conclusion: A healthy lifestyle was associated with a lower risk of PD, and it’s important to identify the effect of genetic risk and sex on PD significantly influenced by lifestyle.