In 2007 Finnish research indicated that regular coffee drinking may be
connected with a reduced risk to have Parkinson’s disease (Hu et al. 2007).
This risk relationship was dependent on the used amount of coffee each day.
There was no significant difference between the genders. The findings were
similar to those of another published study (Ascherio et al. 2001). The
biological risk reducing mechanism behind this finding is still unclear but caffeine is considered to be the neuroprotective factor. Other possible
elements may not be ruled out either, however.
Caffeine is assumed to influence the strength of Parkinson medication by
lengthening the effect of levodopa when it is consumed prior to taking the
drug (Chand 2006). The amount was delimited to 3 or 4 cups of the drink
daily. Those consuming at least 4 cups of coffee obtained slightly better
results than those hardly using any coffee at all as reported in cross-sectional
research on lung performance (Nettleton et al. 2009). Thus
coffee appears to make lungs more effective. Parkinson postia has reported
on some of the above stated studies in the past.
Then, is caffeine good for all Parkinson patients? The last mentioned finding
was applicable to non-smokers (or to those who discontinued smoking) only
(Nettleton et al. 2009). In a follow-up study, an elderly woman’s memory
deteriorated less when she consumed caffeine containing drinks or tea;
caffeine consumption had no effect on memory of men (Ritchie et al. 2007).
Genetic predisposition adds its own meaning: some people are fast caffeine
metabolizers while others are slow caffeine metabolizers (Cornellis et al.
2006). Nonfatal myocardial infarction (MI) was noted as an interesting health
factor. “Intake of coffee was associated with an increased risk of nonfatal MI only among individuals with slow caffeine metabolism, suggesting that
caffeine plays a role in this association” (Cornellis et al. 2006). Three or more
cups per day posed a problem. This would mean that slow caffeine
metabolizers may need to delimit coffee drinking to 1-2 cups a day.
Coffee is essentially considered a stimulant but it has also become a health
food item. It may even enhance the outcome of Parkinson medication. For
those PD patients who cannot tolerate medical preparations used to improve
the quality of levadopa these findings may be of consequence.
How then may coffee breaks be organized as part of every day activities
when selection of food items, measurements of medicine in relation to
nutrition, exercise breaks, and finding the right time to take a nap define the
rhythm of the day? When would be the best time for coffee?
Ascherio A et al. Prospective study of caffeine consumption and risk of Parkinson's disease in men and women. Annals of Neurology 2001; 50 (1):
Chand, P. Effects of caffeine on levodopa pharmacokinetics and
pharmacodynamics in Parkinson disease. Neurology 2006; 67: 897-89.
Cornellis MC et al. Coffee, CYP1A2 Genotype, and Risk of Myocardial
Hu G et al. Coffee and tea consumption and the risk of Parkinson’s disease.
Movement Disorders 2007; 22 (15): 2242-2248.
Nettleton JA et al. Coffee Intake, Smoking, and Pulmonary Function in the
Atherosclerosis Risk in Communities Study. Am J Epidemiol 2009; 169 (12):
Ritchie K et al. The neuroprotective effects of caffeine: A prospective
population study (the Three City Study). Neurology 2007; 69: 536-545.
Ross GW et al. Association of coffee and caffeine intake with the risk of
Parkinson disease. JAMA 2000; 283 (20): 2674-2679.
PAIN MANAGEMENT GUIDELINES 1. Use a multi-modal drug approach. Combine opioids with non-opioids and adjuvant analgesics as indicated. 2. Base administration schedule on the analgesic's duration of effect. Best to use sustained release opioids for scheduled dosing and always use immediate release opioids for rescue or breakthrough dosing. Do not crush or chew extended-release p