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Algotsson C, Rosso A, Elmståhl S, Siennicki-Lantz A. Prevalence and functional impact of parkinsonian signs in older adults from the Good Aging in Skåne study. Parkinsonism Relat Disord 2023; 111:105416. [PMID: 37130449 DOI: 10.1016/j.parkreldis.2023.105416] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Revised: 03/05/2023] [Accepted: 04/23/2023] [Indexed: 05/04/2023]
Abstract
INTRODUCTION Mild parkinsonian signs (MPS) have been characterized by several definitions, using the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS). We aimed to investigate the prevalence of MPS and their association with functional level and comorbidities in the oldest old. METHOD Community-dwelling older adults (n = 559, median age 85, range 80-102 years) were examined regarding MPS, possible parkinsonism (PP) and subthreshold parkinsonism (SP) according to four previously used definitions and concerning the impact of parkinsonian signs on cognitive, physical, and autonomic function. MPS, PP and SP are different terms describing a very similar phenomenon and there is no gradation between these. In two of the four definitions more advanced symptoms were categorized as parkinsonism. RESULTS Median UPDRS score in the whole study group was 10 points (range: 0-58) and was predominated by bradykinesia. MPS/PP/SP were present in 17-85%, and parkinsonism in 33-71% of the cohort. Independently of age and gender, MPS/PP/SP and especially parkinsonism, were associated with a higher risk of fear of falling and accomplished falls, with lower: cognition, ADL, physical activity and quality of life, and with urinary incontinence, obstipation and orthostatic intolerance. CONCLUSIONS In a population of older adults above 80 years, MPS are highly prevalent as well as more advanced symptoms defined as parkinsonism, and only 9-17% of the cohort is symptom-free. Predominance of bradykinesia in the oldest old might indicate a need for revision of MPS definitions to improve their sensibility.
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Affiliation(s)
- Charlotte Algotsson
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Sweden.
| | - Aldana Rosso
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Sweden
| | - Arkadiusz Siennicki-Lantz
- Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Sweden
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Oveisgharan S, Yu L, Barnes LL, Agrawal S, Schneider JA, Bennett DA, Buchman AS. Association of Statins With Cerebral Atherosclerosis and Incident Parkinsonism in Older Adults. Neurology 2022; 98:e1976-e1984. [PMID: 35321928 PMCID: PMC9141626 DOI: 10.1212/wnl.0000000000200182] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 01/25/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND The burden of cerebrovascular disease pathologies is associated with progressive parkinsonism in older adults. We tested the hypothesis that older adults using statins have a lower risk of developing parkinsonism. METHODS We studied older adults with annual clinical testing of four parkinsonian signs and assessment of statin use based on inspection of all medications. Parkinsonism was present if there was clinical evidence of 2 or more parkinsonian signs. Postmortem brain exam collected indices of pathologies including atherosclerosis of the large vessels of the Circle of Willis. We examined if baseline statin use was related to incident parkinsonism. Then in decedents, we examined whether statin use prior to death was related to pathologies and whether pathologies linked the association of statin use with parkinsonism. RESULTS Mean age of the participants (n=2841) at study baseline was 76.3 (SD=7.4) years, and 75% were women. During an average follow-up of 6 years (mean=5.6, SD=4.9), 50% (n=1432) of participants developed parkinsonism. Statin use at baseline (n=936) was associated with a lower risk of parkinsonism (HR=0.84, 95%CI: 0.74-0.96, p=0.008) controlling for demographics, vascular risk factors and diseases. Among the decedents [n=1044, age at death (mean=89.2, SD=6.7)], statin-use prior to death was associated with a lower odds of atherosclerosis (OR=0.63, 95%CI: 0.50-0.79, p<0.001). In a mediation analysis, both a direct (OR=0.73, 95%CI: 0.54-0.93, p=0.008) and an indirect (OR=0.92, 95%CI: 0.88-0.97, p=0.002) pathway via less severe atherosclerosis linked statins to parkinsonism indicating that atherosclerosis mediated 17% of the association between statins and parkinsonism. CONCLUSION Adults using statins have a lower risk of parkinsonism that may be partially mediated by a lower odds of brain atherosclerosis. These findings highlight the role of cerebrovascular pathologies in late-life parkinsonism and suggest a potential role for statins in decreasing its magnitude.
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Affiliation(s)
- Shahram Oveisgharan
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.,Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Sonal Agrawal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.,Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Aron S Buchman
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
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Peng Z, Zhou R, Liu D, Cui M, Yu K, Yang H, Li L, Liu J, Chen Y, Hong W, Huang J, Wang C, Ma J, Zhou H. Association Between Metabolic Syndrome and Mild Parkinsonian Signs Progression in the Elderly. Front Aging Neurosci 2021; 13:722836. [PMID: 34658837 PMCID: PMC8518184 DOI: 10.3389/fnagi.2021.722836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 09/03/2021] [Indexed: 11/13/2022] Open
Abstract
Background: This study investigated the impact of metabolic syndrome on the progression from mild parkinsonian signs (MPS) to Parkinson's disease (PD). Methods: A total of 1,563 participants with MPS completed 6 years of follow-up. The diagnosis of metabolic syndrome was made according to Adult Treatment Panel III of the National Cholesterol Education Program. The evaluations of MPS and PD were based on the motor portion of the Unified Parkinson's Disease Rating Scale. Cox proportional hazard models were used to identify the association between metabolic syndrome and PD conversion. Results: Of the 1,563 participants, 482 (30.8%) with MPS developed PD at the end of the follow-up. Metabolic syndrome (HR: 1.69, 95% CI: 1.29-2.03) was associated with the risk of PD conversion. Metabolic syndrome was associated with the progression of bradykinesia (HR: 1.85, 95% CI: 1.43-2.34), rigidity (HR: 1.36, 95% CI: 1.19-1.57), tremor (HR: 1.98, 95% CI: 1.73-2.32), and gait/balance impairment (HR: 1.66, 95% CI: 1.25-2.11). The effect of metabolic syndrome on the progression of bradykinesia and tremor was nearly two fold. Participants treated for two or three to four components of metabolic syndrome, including high blood pressure, high fasting plasma glucose, hypertriglyceridemia, and low HDL-C, had a lower risk of PD conversion. Conclusion: Metabolic syndrome increased the risk of progression from MPS to PD. Participants treated for two or more components of metabolic syndrome had a lower risk of PD conversion.
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Affiliation(s)
- Zeyan Peng
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Rui Zhou
- Department of Neurology, Army Medical Center of PLA, Chongqing, China
| | - Dong Liu
- Southwest Hospital, Army Medical University, Chongqing, China
| | - Min Cui
- State Key Laboratory of Trauma, Army Medical Center of PLA, Chongqing, China
| | - Ke Yu
- Department of Neurology, The General Hospital of Central Theater Command, Wuhan, China
| | - Hai Yang
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Ling Li
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Juan Liu
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Yang Chen
- Department of Neurology, The First Affiliated Hospital of Bengbu Medical College, Bengbu, China
| | - Wenjuan Hong
- Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China
| | - Jie Huang
- Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China
| | - Congguo Wang
- Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China
| | - Jingjing Ma
- Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China
| | - Huadong Zhou
- Department of Neurology, The General Hospital of Western Theater Command, Chengdu, China
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Buchanan SM, Richards M, Schott JM, Schrag A. Mild Parkinsonian Signs: A Systematic Review of Clinical, Imaging, and Pathological Associations. Mov Disord 2021; 36:2481-2493. [PMID: 34562045 DOI: 10.1002/mds.28777] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 07/29/2021] [Accepted: 08/09/2021] [Indexed: 11/07/2022] Open
Abstract
Mild parkinsonian signs (MPS) have been widely studied during the past 3 decades and proposed as a risk marker for neurodegenerative disease. This systematic review explores the epidemiology, clinical and prognostic associations, radiological features, and pathological findings associated with MPS in older adults free from neurodegenerative disease. We find that MPS as currently defined are strongly associated with increasing age and increased risk of development of Parkinson's disease (PD), all-cause dementia, disability, and death. Positive associations with later PD are found mainly in younger populations and those with other features of prodromal PD. There are currently no consistent radiological findings for MPS, and pathological studies have shown that MPS, at least in the oldest old, are often underpinned by mixed neuropathologies, including those associated with Alzheimer's disease, cerebrovascular disease, nigral neuronal loss, and Lewy bodies. Different subcategories of MPS appear to convey varying risk and specificity for PD and other outcomes. MPS overall are not specific for parkinsonian disorders and, although associated with increased risk of PD, can reflect multiple pathologies, particularly in older individuals. "Mild motor signs" appears a more appropriate term to avoid prognostic and pathological implications, and larger future studies to prospectively examine outcomes and associations of specific MPS subcategories are required. © 2021 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sarah M Buchanan
- Dementia Research Centre, University College London Institute of Neurology, University College London, London, United Kingdom
- Otago Medical School, University of Otago, Dunedin, New Zealand
| | - Marcus Richards
- Medical Research Council Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre, University College London Institute of Neurology, University College London, London, United Kingdom
| | - Anette Schrag
- Department of Clinical Neurosciences, UCL Institute of Neurology University College London, London, United Kingdom
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5
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Rosano C, Metti AL, Rosso AL, Studenski S, Bohnen NI. Influence of Striatal Dopamine, Cerebral Small Vessel Disease, and Other Risk Factors on Age-Related Parkinsonian Motor Signs. J Gerontol A Biol Sci Med Sci 2021; 75:696-701. [PMID: 31425570 DOI: 10.1093/gerona/glz161] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2018] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE Parkinsonian motor signs are common and disabling in older adults without Parkinson's disease (PD), but its risk factors are not completely understood. We assessed the influence of striatal dopamine levels, cerebral small vessel disease, and other factors on age-related parkinsonian motor signs in non-PD adults. METHODS Striatal dopamine transporter (DAT) binding was quantified via [11C]-CFT positron emission tomography in 87 neurologically intact adults (20-85 years, 57.47% female) with concurrent data on: Unified Parkinson's Disease Rating Scale motor (UPDRSm), white matter hyperintensities (WMH), and other risk factors (grip strength, vibratory sensitivity, cardio- and cerebro-vascular comorbidities). Sex-adjusted nonparametric models first estimated the associations of age, DAT, WMH, and other factors with UPDRSm; next, interactions of age by DAT, WMH, or other factors were tested. To quantify the influence of DAT, WMH, and other risk factors on the main association of age with UPDRSm, multivariable mediation models with bootstrapped confidence intervals (CI) were used. RESULTS Older age, lower DAT, higher WMH, and worse risk factors significantly predicted worse UPDRSm (sex-adjusted p < .04 for all). DAT, but not WMH or other factors, positively and significantly interacted with age (p = .02). DAT significantly reduced the age-UPDRSm association by 30% (results of fully adjusted mediation model: indirect effect: 0.027; bootstrapped 95% CI: 0.0007, 0.074). CONCLUSIONS Striatal dopamine appears to influence to some extent the relationship between age and parkinsonian signs. However, much of the variance of parkinsonian signs appears unexplained. Longitudinal studies to elucidate the multifactorial causes of this common condition of older age are warranted.
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Affiliation(s)
- Caterina Rosano
- Department of Epidemiology, Graduate School of Public Health, Pennsylvania
| | - Andrea L Metti
- Department of Epidemiology, Graduate School of Public Health, Pennsylvania
| | - Andrea L Rosso
- Department of Epidemiology, Graduate School of Public Health, Pennsylvania
| | - Stephanie Studenski
- Department of Geriatric Medicine, School of Medicine, University of Pittsburgh, Pennsylvania
| | - Nicolaas I Bohnen
- Departments of Radiology, Neurology and Division of Nuclear Medicine and Department of Veterans Affairs, University of Michigan, Ann Arbor
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White matter hyperintensities and the progression from mild parkinsonian signs to parkinsonism and Parkinson's disease. Neurobiol Aging 2020; 96:267-276. [PMID: 33130544 DOI: 10.1016/j.neurobiolaging.2020.08.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Revised: 08/01/2020] [Accepted: 08/03/2020] [Indexed: 12/11/2022]
Abstract
This study investigated the impact of white matter hyperintensities (WMHs) on the progression from mild parkinsonian signs (MPS) to parkinsonism and Parkinson's disease (PD). Participants with MPS completed 5 years of follow-up. WMHs were divided into periventricular WMHs and deep WMHs according to magnetic resonance imaging scans. The diagnosis of MPS, parkinsonism, and PD was based on the motor portion of the Unified Parkinson's Disease Rating Scale. Cox proportional hazard models were used to identify the association between WMHs and MPS progression. Of the 636 participants, 166 (26.1%) with MPS developed parkinsonism and PD after follow-up. After adjusting for potential factors, severe WMHs were associated with an increased risk of MPS progression, moderate and severe periventricular WMHs and severe deep WMHs were associated with the risk of MPS progression, and severe WMHs were associated with the progression of gait/balance impairment, bradykinesia, and rigidity. Additionally, participants treated for vascular risk factors such as hypertension, diabetes mellitus, and hypercholesterolemia had a lower risk of MPS progression.
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7
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Kishi M, Wada-Isoe K, Hanajima R, Nakashima K. Predictors for Incident Mild Parkinsonian Signs in Older Japanese. Yonago Acta Med 2019; 63:1-7. [PMID: 32158327 DOI: 10.33160/yam.2020.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 11/21/2019] [Indexed: 12/12/2022]
Abstract
Background Mild parkinsonian signs are important clinical symptoms related to the decline of motor and cognitive functions. We aimed to identify predictors for the incidence of mild parkinsonian signs in older Japanese by conducting an 8-year longitudinal community-based cohort study. Methods Participants aged 65 years or older, living in Ama-cho, a rural island town in western Japan, underwent a baseline assessment of motor function, cognitive function, depression score, the Pittsburgh Sleep Quality Index (PSQI), the Tanner questionnaire, and cerebral white matter lesions on brain magnetic resonance imaging from 2008 to 2010, and then underwent a follow-up neurological examination from 2016 to 2017. Mild parkinsonian signs were defined according to a modified Unified Parkinson's Disease Rating Scale score. Results Of the 316 participants without mild parkinsonian signs at baseline, 94 presented with incident mild parkinsonian signs at follow-up. In addition to an absence of exercise habits, a higher score on the Tanner questionnaire, PSQI, and deep white-matter hyperintensity Fazekas scores were significant independent predictors for incidence of mild parkinsonian signs. Conclusion We suggest multiple factors related to incidence of mild parkinsonian signs. Vascular lesions and sleep disorders are associated with a pathogenesis of mild parkinsonian signs, the Tanner questionnaire is useful for early detection of subclinical mild parkinsonian signs, and exercise has a possibility of being associated with preventing onset of mild parkinsonian signs.
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Affiliation(s)
- Masafumi Kishi
- Division of Neurology, Department of Brain and Neurosciences, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Kenji Wada-Isoe
- Division of Neurology, Department of Brain and Neurosciences, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan.,Department of Dementia Research, Kawasaki Medical School, Okayama 700-8505, Japan
| | - Ritsuko Hanajima
- Division of Neurology, Department of Brain and Neurosciences, School of Medicine, Tottori University Faculty of Medicine, Yonago 683-8503, Japan
| | - Kenji Nakashima
- National Hospital Organization Matsue Medical Center, Matsue 690-8556, Japan
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Kon T, Tomiyama M, Wakabayashi K. Neuropathology of Lewy body disease: Clinicopathological crosstalk between typical and atypical cases. Neuropathology 2019; 40:30-39. [PMID: 31498507 DOI: 10.1111/neup.12597] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Revised: 07/30/2019] [Accepted: 07/31/2019] [Indexed: 12/21/2022]
Abstract
Lewy body disease (LBD) is characterized by the presence of Lewy bodies (LBs) and Lewy neurites and comprises a diagnostic spectrum that includes Parkinson's disease (PD), PD with dementia, and dementia with LBs. LBs and Lewy neurites are insoluble aggregates composed mainly of phosphorylated α-synuclein and can be widely distributed throughout the central and peripheral nervous systems. The distribution of LBs may determine the LBD phenotype. Braak hypothesized that Lewy pathology progresses ascendingly from the peripheral nervous system to the olfactory bulbs and brainstem and then to other brain regions. Braak's PD staging suggests that LBD is a prion-like disease. Most typical PD cases fit with Braak's PD staging, but the scheme fails in some cases. Alzheimer's disease, progressive supranuclear palsy, corticobasal syndrome, multiple system atrophy, frontotemporal lobar degeneration, Creutzfeldt-Jakob disease, cerebrovascular diseases, and essential tremor are common misdiagnoses for pathologically confirmed LBD. LBD exhibits considerable heterogeneity in both clinical and pathological settings, which makes clinical diagnosis challenging.
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Affiliation(s)
- Tomoya Kon
- Department of Neuropathology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan.,Department of Neurology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Masahiko Tomiyama
- Department of Neurology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
| | - Koichi Wakabayashi
- Department of Neuropathology, Institute of Brain Science, Hirosaki University Graduate School of Medicine, Hirosaki, Japan
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9
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Prasuhn J, Piskol L, Vollstedt EJ, Graf J, Schmidt A, Tadic V, Tunc S, Hampf J, Warrlich E, Bibergeil C, Hagenah J, Klein C, Kasten M, Brüggemann N. Non-motor symptoms and quality of life in subjects with mild parkinsonian signs. Acta Neurol Scand 2017; 136:495-500. [PMID: 28345787 DOI: 10.1111/ane.12760] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/06/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Mild parkinsonian signs (MPS) are frequent in the elderly population and associated with the presence of risk markers for Parkinson's disease (PD). Both MPS and non-motor signs may be present in prodromal PD and may significantly impair quality of life (QoL). OBJECTIVE To disentangle the contribution of motor impairment and extra-motor manifestations to QoL in subjects with MPS (n=63), manifest PD (n=69), disorders with motor symptoms due to non-neurodegenerative diseases (n=213) and healthy controls (n=258). METHODS Subjects with MPS, healthy controls, disease controls (patients with motor impairment due to, eg, arthrosis and spondylosis), and PD patients (total n=603) were selected from a large epidemiological longitudinal study, the EPIPARK cohort. Motor function was determined using the UPDRSIII protocol, and information on depressive symptoms, anxiety, sleep, and QoL was assessed via rating scales and data were analyzed. RESULTS Depressive symptoms, anxiety, and sleep problems were equally frequent in the MPS group and controls. Health-related QoL was slightly reduced in the MPS group. Motor impairment and its extent was comparable between the MPS group and disease controls (UPDRSIII 5-6 points). Higher motor dysfunction was associated with lower QoL. Depressive symptoms, but not anxiety and daytime sleepiness, was significant predictors of general QoL, independent of motor function. CONCLUSIONS Quality of life is slightly decreased in an elderly population with MPS. QoL is associated with severity of motor impairment but also with non-motor aspects, ie, depressive symptoms. Follow-up studies in large cohorts are warranted to determine the natural course of MPS and its impact on QoL.
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Affiliation(s)
- J. Prasuhn
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - L. Piskol
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - E.-J. Vollstedt
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Psychiatry and Psychotherapy; University of Lübeck; Lübeck Germany
| | - J. Graf
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Neurology; University of Lübeck; Lübeck Germany
| | - A. Schmidt
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Kurt Singer Institute for Music Physiology and Musicians’ Health; Hanns Eisler School of Music Berlin; Berlin Germany
- Berlin Center for Musicians’ Medicine; Charité - University Medicine Berlin; Berlin Germany
| | - V. Tadic
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Neurology; University of Lübeck; Lübeck Germany
| | - S. Tunc
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Neurology; University of Lübeck; Lübeck Germany
| | - J. Hampf
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - E. Warrlich
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - C. Bibergeil
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - J. Hagenah
- Department of Neurology; Westküstenklinikum Heide; Heide Germany
| | - C. Klein
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
| | - M. Kasten
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Psychiatry and Psychotherapy; University of Lübeck; Lübeck Germany
| | - N. Brüggemann
- Institute of Neurogenetics; University of Lübeck; Lübeck Germany
- Department of Neurology; University of Lübeck; Lübeck Germany
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10
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Seiffert P, Derejczyk J, Kawa J, Marcisz C, Czernek M, Szymszal J, Kapko W, Bugdol M, Torbus A, Stępień-Wyrobiec O. Frailty phenotype and the role of levodopa challenge test in geriatric inpatients with mild parkinsonian signs. Biogerontology 2017; 18:641-650. [PMID: 28612154 DOI: 10.1007/s10522-017-9716-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2017] [Accepted: 06/07/2017] [Indexed: 12/23/2022]
Abstract
Deficiency in dopaminergic system function may be one of the hypothetical reasons of the frailty syndrome but its role still remains unclear. The aim of our study was to assess the frailty phenotype prevalence in geriatric inpatients with mild parkinsonian signs (MPS) and to investigate levodopa test in the frail patients with MPS. We examined 118 participants: 90 with MPS and 28 in control group (without MPS). The frailty syndrome presence was evaluated by the Fried criteria. Deficiency in dopaminergic system function was assessed by one of the modifications of an acute levodopa challenge test (LCT): in MPS group every patient was examined by performing Up and Go Test and also Step Test before and 3 h after taking 125 mg of Madopar (levodopa + benserazide). Sixty-nine study subjects (58%) met criteria for frailty. Fifty-five participants in MPS group (61.1% of MPS group) and fourteen (50%) in control group. All of the patients that scored positive in walk speed criterion of frailty were frail. When all MPS patients were considered, the number of components scored positive for frailty was directly related to the walk speed (r = -0.70, p < 0.0001). In MPS group LCT scores were significantly higher for frailty patients compared to non-frailty (p = 0.0027). When all MPS patients were considered, the number of components scored positive for frailty was directly related LCT score (r = 0.37, p = 0.0004). There was a relationship between LCT and walk speed (r = -0.31, p = 0.0032). Our observations provide new information about the relationship between frailty and MPS, suggest the need for increased awareness of frailty in MPS patients and conversely. Our study provides data for a discussion on pathophysiological background of the frailty syndrome (FS), emphasizing the theories of the important impact of dopaminergic system deficit and encourages further research on the role of LCT in measuring it.
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Affiliation(s)
- Piotr Seiffert
- John Paul II Geriatric Hospital, Research and Development Centre, Katowice, Poland.
| | - Jarosław Derejczyk
- John Paul II Geriatric Hospital, Research and Development Centre, Katowice, Poland
| | - Jacek Kawa
- Silesian University of Technology, Zabrze, Poland
| | - Czesław Marcisz
- Department of Gerontology and Geriatric Nursing, School of Health Sciences, Medical University of Silesia, Katowice, Poland
| | - Małgorzata Czernek
- John Paul II Geriatric Hospital, Research and Development Centre, Katowice, Poland
| | - Jan Szymszal
- Silesian University of Technology, Katowice, Poland
| | - Wojciech Kapko
- John Paul II Geriatric Hospital, Research and Development Centre, Katowice, Poland
| | | | - Anna Torbus
- John Paul II Geriatric Hospital, Research and Development Centre, Katowice, Poland
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