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Parkinsonianlike signs and risk of incident Alzheimer disease in older persons.

Abstract

BACKGROUND

Parkinsonianlike signs are common in older persons, but little is known about how their severity or rate of progression is related to the development of Alzheimer disease (AD) or decline in cognition.

OBJECTIVE

To examine the association of progression of parkinsonianlike signs with incident AD and cognitive decline.

DESIGN

Longitudinal cohort study.

PARTICIPANTS AND SETTING

For up to 8 years, 824 older Catholic clergy members without clinical evidence of AD or Parkinson disease at baseline underwent annual clinical evaluations that included a modified version of the Unified Parkinson's Disease Rating Scale (UPDRS), detailed cognitive function testing, and clinical classification of AD.

MAIN OUTCOME MEASURES

Clinically diagnosed AD and change in global and specific measures of cognitive function.

RESULTS

During an average of 4.6 years of observation, 114 persons developed AD. The global UPDRS score increased in 79% of participants, who were divided into tertiles with the least, moderate, or most rapid progression. We examined the relationship of progression to disease risk in a proportional hazards model that controlled for baseline global UPDRS and demographic variables. Compared with the 21% without progression, risk of AD more than doubled in the subgroup with the least progression (P =.08), more than tripled in the moderate subgroup (P =.02), and increased more than 8-fold in the subgroup with the most rapid progression (P<.001). This effect was mainly due to worsening gait and rigidity. Rate of change on the global UPDRS measure was inversely correlated with rate of change on a global measure of cognitive function (r = -0.64).

CONCLUSION

Progression of parkinsonianlike signs in old age is associated with decline in cognitive function and the development of AD.

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  • Publisher Full Text
  • Authors+Show Affiliations

    ,

    Rush Alzheimer's Disease Center and Rush Institute for Healthy Aging and the Department of Neurological Sciences, Rush-Presbyterian-St Luke's Medical Center, Chicago, IL 60612, USA. rwilson@rush.edu

    , , ,

    Source

    Archives of neurology 60:4 2003 Apr pg 539-44

    MeSH

    Aged
    Alzheimer Disease
    Apolipoproteins E
    Cognition
    Cohort Studies
    Disease Progression
    Female
    Humans
    Longitudinal Studies
    Male
    Parkinson Disease
    Risk Assessment
    Risk Factors
    United States

    Pub Type(s)

    Journal Article
    Research Support, U.S. Gov't, P.H.S.

    Language

    eng

    PubMed ID

    12707067

    Citation

    Wilson, Robert S., et al. "Parkinsonianlike Signs and Risk of Incident Alzheimer Disease in Older Persons." Archives of Neurology, vol. 60, no. 4, 2003, pp. 539-44.
    Wilson RS, Schneider JA, Bienias JL, et al. Parkinsonianlike signs and risk of incident Alzheimer disease in older persons. Arch Neurol. 2003;60(4):539-44.
    Wilson, R. S., Schneider, J. A., Bienias, J. L., Evans, D. A., & Bennett, D. A. (2003). Parkinsonianlike signs and risk of incident Alzheimer disease in older persons. Archives of Neurology, 60(4), pp. 539-44.
    Wilson RS, et al. Parkinsonianlike Signs and Risk of Incident Alzheimer Disease in Older Persons. Arch Neurol. 2003;60(4):539-44. PubMed PMID: 12707067.
    * Article titles in AMA citation format should be in sentence-case
    TY - JOUR T1 - Parkinsonianlike signs and risk of incident Alzheimer disease in older persons. AU - Wilson,Robert S, AU - Schneider,Julie A, AU - Bienias,Julia L, AU - Evans,Denis A, AU - Bennett,David A, PY - 2003/4/23/pubmed PY - 2003/5/8/medline PY - 2003/4/23/entrez SP - 539 EP - 44 JF - Archives of neurology JO - Arch. Neurol. VL - 60 IS - 4 N2 - BACKGROUND: Parkinsonianlike signs are common in older persons, but little is known about how their severity or rate of progression is related to the development of Alzheimer disease (AD) or decline in cognition. OBJECTIVE: To examine the association of progression of parkinsonianlike signs with incident AD and cognitive decline. DESIGN: Longitudinal cohort study. PARTICIPANTS AND SETTING: For up to 8 years, 824 older Catholic clergy members without clinical evidence of AD or Parkinson disease at baseline underwent annual clinical evaluations that included a modified version of the Unified Parkinson's Disease Rating Scale (UPDRS), detailed cognitive function testing, and clinical classification of AD. MAIN OUTCOME MEASURES: Clinically diagnosed AD and change in global and specific measures of cognitive function. RESULTS: During an average of 4.6 years of observation, 114 persons developed AD. The global UPDRS score increased in 79% of participants, who were divided into tertiles with the least, moderate, or most rapid progression. We examined the relationship of progression to disease risk in a proportional hazards model that controlled for baseline global UPDRS and demographic variables. Compared with the 21% without progression, risk of AD more than doubled in the subgroup with the least progression (P =.08), more than tripled in the moderate subgroup (P =.02), and increased more than 8-fold in the subgroup with the most rapid progression (P<.001). This effect was mainly due to worsening gait and rigidity. Rate of change on the global UPDRS measure was inversely correlated with rate of change on a global measure of cognitive function (r = -0.64). CONCLUSION: Progression of parkinsonianlike signs in old age is associated with decline in cognitive function and the development of AD. SN - 0003-9942 UR - https://www.unboundmedicine.com/medline/citation/12707067/Parkinsonianlike_signs_and_risk_of_incident_Alzheimer_disease_in_older_persons_ L2 - https://jamanetwork.com/journals/jamaneurology/fullarticle/vol/60/pg/539 DB - PRIME DP - Unbound Medicine ER -