The final protagonist in the ecogenetic theory of PD is normal ageing. Ageing results in a multitude of physiological changes that could contribute to increased risk for neurodegen-erative disease. Well characterised changes in the central nervous system (CNS), cardiovascular system (CVS), metabolic pathways and gene-expression profiles, many of which are highly inter-related, all contribute to this increased risk. In terms of PD, the effect of ageing appears to shift the aetiological balance more towards environmental risk factors. In other words, the older an individual gets, the greater the environmental component to PD risk. This idea is illustrated in the results of twin studies and family studies.
This extremely rudimentary summary of the major concepts of the ecogenetic theory of PD seeks only to provide a flavour for the complex and multifactorial nature of the aetiology of PD. A more comprehensive summary of age-environment and gene-environment interactions in the pathogenesis of PD can be found in a recent review article on the topic (Le Couteur et al., 2002).
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