Mild parkinsonian signs in a community-dwelling elderly population sample in Japan

Uemura, Yoshiko; Wada‐Isoe, Kenji; Nakashita, Satoko; Nakashima, Kenichiro

doi:10.1016/j.jns.2011.02.013

Cited by 21 publications

(38 citation statements)

References 31 publications

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“…Individuals developing similar motor signs but without fulfilling the full criteria for parkinsonism have been referred to as having 'mild parkinsonian signs' [3] . The prevalence of MPS varies across studies, with reports of between 20 and 40% in community-based populations of older individuals [4,12,13] . Some studies suggest that MPS reflects true neurodegeneration, with postmortem studies demonstrating nigral neuronal loss and/or the presence of Lewy bodies in 39% [14] .…”

Section: Discussionmentioning

confidence: 99%

“…The UPDRS has since been applied outside of its original intention, to detect early prodromal stages of PD, for example, in high-risk conditions [2] and to identify the presence of mild parkinsonian signs (MPS) [3,4] . The International Parkinson and Movement Disorder Society (MDS) recently sponsored an extensive revision of the rating scale referred to as the MDS Unified Parkinson's Disease Rating Scale (MDS-UPDRS) [5] .…”

Section: Introductionmentioning

confidence: 99%

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Age, Gender, Comorbidity, and the MDS-UPDRS: Results from a Population-Based Study

Keezer¹,

Wolfson²,

Postuma

2016

Neuroepidemiology

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Background: Understanding sources of variation in International Parkinson and Movement Disorder Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS) scores is essential for planning clinical trials in Parkinson's disease and interpreting studies of mild parkinsonian signs. Methods: We describe the characteristics of the MDS-UPDRS in a population-based sample of individuals without parkinsonism. Multiple linear regression and Spearman's rank correlation coefficients were used to examine potential associations. Results: Among 194 consecutive individuals without parkinsonism, the mean total MDS-UPDRS score was 12.5 (SD 9.8). Sixty-nine percent (134/193) had motor examination (Part III) scores of 2 or more, 16% (30/194) had scores of 10 or more. Female sex, arthritis or spondylosis, diabetes mellitus, and essential tremor were found to be associated with statistically significant increases in MDS-UPDRS Part III scores. For every 10-year increase in age, the Part III score was greater on average by 2.2 (1.5-2.8). Conclusions: Elevated MDS-UPDRS scores are common in the general population. The overall burden of motor signs of parkinsonism is especially high in older age groups, in women, and in those with particular comorbidities. Whether this represents evidence of a subclinical neurodegenerative process or the effect of comorbid conditions requires further examination.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Age, Gender, Comorbidity, and the MDS-UPDRS: Results from a Population-Based Study

Keezer¹,

Wolfson²,

Postuma

2016

Neuroepidemiology

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“…This study was conducted in Ama-cho, a rural island town in the northwestern part of Japan, located 70 km from Yonago City (6). To be eligible for the study, subjects were required to be living and to be legally residing in the town on October 1, 2009.…”

Section: Subjectsmentioning

confidence: 99%

Clinical assessment and prevalence of parkinsonism in Japanese elderly people

et al. 2015

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“…1,15,16 Prospective data providing estimates of its incidence and risk factors are crucial for the rational allocation of health resources and research efforts to decrease parkinsonism in older adults. The current study fills an important gap in our knowledge about parkinsonism by providing prospective data on age-and sex-specific incidence rates of parkinsonism in older adults without a clinical diagnosis of PD.…”

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confidence: 99%

“…15,[17][18][19] Parkinsonism in this study was based on 26 items from the UPDRS including both gait and nongait items. 6 Parkinsonian gait was the most frequent isolated sign as well as the most common sign observed in combination with the other parkinsonian signs in individuals developing parkinsonism.…”

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confidence: 99%

Incident parkinsonism in older adults without Parkinson disease

Buchman

Leurgans

et al. 2016

Neurology

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Objective: To determine the incidence of parkinsonism in community-dwelling older adults without Parkinson disease.Methods: Four parkinsonian signs were assessed with a modified motor portion of the Unified Parkinson's Disease Rating Scale in 2,001 older adults without parkinsonism. We used Cox proportional hazards models to determine the associations of age and sex with incident parkinsonism (2 or more signs). We calculated the number of events per 1,000 person-years of observation in 3 age strata. Next, we investigated several potential risk factors for incident parkinsonism. Then, we examined longitudinal progression of parkinsonism using discrete-time multistate Markov models.Results: Average age at baseline was 76.8 years (SD 7.62 years). During an average of 5 years of follow-up, 964/2,001 (48.2%) developed parkinsonism. Age (hazard ratio [HR] 1.09, 95% confidence interval [CI] 1.08-1.10) but not male sex (HR 1.06, 95% CI 0.91-1.23) was associated with incident parkinsonism. The incidence of parkinsonism per 1,000 person-years of follow-up was 36.0 for adults ,75 years of age, 94.8 for those 75-84, and 160.5 for those 85 years or older. Depressive symptoms, neuroticism, urinary incontinence, sleep complaints, and chronic health conditions were associated with incident parkinsonism. Secondary analyses suggest that risk factors are linked with incident parkinsonism via early motor signs of parkinsonism and cognitive function. Transition modeling suggests that while parkinsonism may fluctuate, it is progressive in most older adults and its risk factors increase the odds of its progression. Motor impairments such as parkinsonian signs are common in older adults without Parkinson disease (PD) and are associated with a wide range of adverse health outcomes. Cross-sectional studies suggest that parkinsonian signs may affect up to half of older adults. Conclusions:1 Since parkinsonism is strongly associated with age, its incidence is likely to increase in our aging population and could constitute a major public health problem. Nonetheless, little data are available regarding age-and sex-specific incidence rates of parkinsonism.In this study, we employed a previously validated categorical measure of parkinsonism to determine the age-and sex-specific incidence of parkinsonism in 2,000 older communitydwelling older adults.2 Then we examined motor and cognitive measures that might capture early signs of parkinsonism and several possible risk factors to determine which were associated with incident parkinsonism.

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Mild parkinsonian signs in a community-dwelling elderly population sample in Japan

Cited by 21 publications

References 31 publications

Age, Gender, Comorbidity, and the MDS-UPDRS: Results from a Population-Based Study

Age, Gender, Comorbidity, and the MDS-UPDRS: Results from a Population-Based Study

Clinical assessment and prevalence of parkinsonism in Japanese elderly people

Incident parkinsonism in older adults without Parkinson disease

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