I ask the question: Is it possible to slow the rate of progression of PD by moving house?

To set the scene for what follows, let me say that I think that there are many types of PD, with each modulated by genetics unique to the individual. So what follows will not apply to everyone.

Suppose that there is a subgroup of PwP whose PD is made to progress by environmental toxins, either man-made or natural.

Suppose, also, that the toxin load varies from place to place: house to house, neighbourhood to neighbourhood, county to county etc..

If these two conditions apply, we can affect the rate of progression by moving house. In particular, we could slow the rate of progression by moving to PD friendly houses or areas.

How would we recognise such places?

Ideally we would have assessments specific to each house. For instance, they could include a chemical analysis of the water supply. Unfortunately, not only would this be expensive but, except for some gross features, we don't know what we are looking for - after all the aetiology of PD is unknown.

Second best would be geographically based measures of disease progression rates. I've not been able to find such statistics. Hopefully, initiatives such as PPMI, will yield such data in the future. But, until then, how can we estimate progression rates with the available data?

I think most people would agree that PD usually has a pre-symptomatic phase lasting several years, where damage is being done to the brain, but without visible effect. And following this there is often a period of several more years of minor symptoms before the PwP presents him/herself to a doctor. This is often followed by another delay before a diagnosis of PD is made. Let's call these times taken together the prediagnosis period.

The prediagnosis period will be longer in areas of slow progression than in areas of fast progression. So, we would expect the average age of diagnosis to be lower in areas of fast progression.

The next approach that comes to mind is that places with slow progression should have a low disease incidence. But, since we are only slowing the progression, not stopping it, and assuming we are in steady state, the difference in incidence rates is limited to the difference in the number of people who died following an early PD diagnosis, rather than following a late PD diagnosis.

Has anyone experienced a changed rate of progression after moving to a different house or area?

John