Abstract
BACKGROUND: Antiplatelet drugs have been hypothesized to be involved in the pathological process of Parkinson's disease (PD) by affecting neuroinflammation and vascular function. However, their association with PD prevalence at the population level remains unclear. This study aimed to investigate the relationship between antiplatelet drug use and PD prevalence among American adults. METHODS: This cross-sectional study included 21,288 participants aged 40 years and older from the 1999-2018 National Health and Nutrition Examination Survey (NHANES). Antiplatelet drug use was assessed through prescription records, and PD diagnosis was based on the use of typical anti-PD medications. The association between antiplatelet drug use and PD prevalence was analyzed using weighted multivariate logistic regression models. RESULTS: After adjusting for multiple confounders, antiplatelet drug use was associated with a higher prevalence of PD (OR = 1.66, 95% CI: 1.08-2.56). Specifically, clopidogrel use was significantly associated with increased prevalence (OR = 1.75, 95% CI: 1.01-3.01), whereas aspirin showed no significant association. Stratified and interaction analyses further revealed that the association with clopidogrel was statistically significant only in diabetic patients (OR = 3.80, 95% CI: 1.68-8.60), whereas no significant association was observed in non-diabetic patients. CONCLUSION: Antiplatelet drug use, particularly clopidogrel, is associated with increased PD prevalence, with this association being particularly pronounced in diabetic patients. However, as a cross-sectional analysis, this study cannot infer causality; furthermore, the medication-based definition of PD may involve diagnostic misclassification. Therefore, these findings should be interpreted with caution. Consideration could be given to enhanced monitoring of neurological symptoms for diabetic patients on long-term clopidogrel therapy. Prospective studies are needed to further explore potential mechanisms and temporal relationships.