Annonaceae fruit consumption is associated with cognitive decline and dementia in degenerative parkinsonism

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Abstract Background High consumption of Annona muricata fruit (soursop, graviola, guanabana, corossol) has been previously identified as a risk factor for atypical parkinsonism in the French Caribbean islands. Annonaceae fruits are consumed worldwide in tropical areas. We tested whether consumption of Annonaceae products could worsen the clinical phenotype of patients with any form of degenerative parkinsonism. Method We analyzed neurological data from 180 Caribbean parkinsonian patients and specifically looked for dose effects of lifelong, cumulative Annonaceae consumption on cognitive performance. Using unsupervised clustering, we identified one cluster with mild/moderate symptoms (N = 102) and one with severe symptoms including cognitive impairment (N = 78). Result We showed that even low cumulative consumption of fruits/juices (>0.2 fruit‐years) or any consumption of herbal tea from Annonaceae worsen disease severity and cognitive deficits in degenerative parkinsonism including Parkinson’s disease (OR fruits‐juices: 3.76 [95% CI: 1.13‐15.18]; OR herbal tea: 2.91 [95% CI: 1.34‐6.56]). Conclusion We suggest that more restrictive public health preventive recommendations should be made regarding Annonaceae products which could increase the risk cognitive impairment and dementia in tropical areas.

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