Findings demonstrate a relationship between lifestyle factors and Parkinson disease (PD) development.

• In this nationwide population-based cohort study of Koreans who underwent health screening ≥3 times between 2002 and 2015 and followed up until December 31, 2015, researchers assessed the association of repeatedly measured lifestyle factors with PD risk.

• Development of PD in 2,665 patients was revealed by the 14-year follow-up.

• Only in males, there was a dose–response inverse association between smoking and PD (ex-smoker, odds ratio [OR] 0.782; current smoker, OR 0.556).

• In both genders, alcohol intake and regular physical activity were found to be associated with decreased PD development.

• However, alcohol intake in males (≤3 per week, OR 0.717; ≥4 per week, OR 0.745) and physical activity in females (moderate, OR 0.792; vigorous, OR 0.830) showed more consistent links with PD development than those of the other gender.