| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
From the Rush Alzheimer’s Disease Center and Rush Institute for Healthy Aging, Departments of Neurological Sciences (Drs. Wilson, Schneider, Evans, and Bennett), Psychology (Dr. Wilson), and Medicine (Dr. Evans), Rush–Presbyterian–St. Luke’s Medical Center, Chicago, IL; and Department of Epidemiology and Preventive Medicine (Dr. Beckett), School of Medicine, University of California, Davis, CA.
Address correspondence and reprint requests to Dr. Robert S. Wilson, Rush Alzheimer’s Disease Center, 1645 West Jackson Boulevard, Suite 675, Chicago, IL 60612; e-mail: rwilson{at}rush.edu
Background: Bradykinesia, gait disturbance, rigidity, and tremor are common motor signs in old age. All of these signs are associated with increased morbidity and mortality, but the extent to which they are progressive is unknown.
Methods: Study participants were 787 older Catholic clergy members without clinically diagnosed PD, related conditions, or dementia at baseline. They were evaluated annually for up to 7 years, with >95% follow-up participation by survivors. Evaluations included administration of a modified version of the motor portion of the Unified PD Rating Scale (UPDRS), from which previously established measures of the global UPDRS and four specific motor signs were derived. Scores represent the percent of the total possible UPDRS score obtained.
Results: At baseline, the global UPDRS score ranged from 0 to 36.3 (mean ± SD, 7.3 ± 6.4). It increased by an average of 0.69 unit per year during follow-up, with more rapid progression in older persons, but there was wide variability with no progression in 21% of subjects and annual increases of up to 8.23 units in the remaining 79%. Of 129 persons who died, 106 had follow-up UPDRS data. In a proportional hazards model, risk of death was associated with both the level of the global UPDRS score at baseline and the annual rate of progression (both p < 0.001). Overall, risk of death in subjects who had some worsening of the global UPDRS score was 2.93 times the rate among those without progression (95% CI, 1.32–6.50). Gait disorder/postural reflex impairment and rigidity worsened, but bradykinesia and tremor did not. Risk of death was associated with worsening of gait/posture but not with the other signs.
Conclusion: Gait disorder and rigidity, as assessed with the modified UPDRS, are usually progressive in old age. Both the severity of the gait disorder and its rate of progression are strongly associated with risk of death.
This article has been cited by other articles:
|
|
 |
|
  V. Novak, K. Hu, M. Vyas, and L. A. Lipsitz Cardiolocomotor Coupling in Young and Elderly People J. Gerontol. A Biol. Sci. Med. Sci., January 1, 2007; 62(1): 86 - 92. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. C. Shah, R. S. Wilson, J. L. Bienias, Z. Arvanitakis, D. A. Evans, and D. A. Bennett Blood pressure and lower limb function in older persons. J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2006; 61(8): 839 - 843. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 K. S M Taylor and C. Counsell Is it Parkinson's disease, and if not, what is it? Practical Neurology, June 1, 2006; 6(3): 154 - 165. [Full Text] [PDF]
|
|
|
|
 |
|
 P. A. Boyle, R. S. Wilson, N. T. Aggarwal, Z. Arvanitakis, J. Kelly, J. L. Bienias, and D. A. Bennett Parkinsonian signs in subjects with mild cognitive impairment Neurology, December 27, 2005; 65(12): 1901 - 1906. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. Elbaz, M. Ripert, B. Tavernier, B. Fevrier, M. Zureik, J. Gariepy, A. Alperovitch, and C. Tzourio Common Carotid Artery Intima-Media Thickness, Carotid Plaques, and Walking Speed Stroke, October 1, 2005; 36(10): 2198 - 2202. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 L. L. Barnes, R. S. Wilson, J. L. Bienias, J. A. Schneider, D. A. Evans, and D. A. Bennett Sex Differences in the Clinical Manifestations of Alzheimer Disease Pathology Arch Gen Psychiatry, June 1, 2005; 62(6): 685 - 691. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
N. Scarmeas, M. Albert, J. Brandt, D. Blacker, G. Hadjigeorgiou, A. Papadimitriou, B. Dubois, M. Sarazin, D. Wegesin, K. Marder, et al. Motor signs predict poor outcomes in Alzheimer disease Neurology, May 24, 2005; 64(10): 1696 - 1703. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. D. Louis, N. Schupf, J. Manly, K. Marder, M. X. Tang, and R. Mayeux Association between mild parkinsonian signs and mild cognitive impairment in a community Neurology, April 12, 2005; 64(7): 1157 - 1161. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. D. Louis, M. X. Tang, N. Schupf, and R. Mayeux Functional Correlates and Prevalence of Mild Parkinsonian Signs in a Community Population of Older People Arch Neurol, February 1, 2005; 62(2): 297 - 302. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. Russmann, J. Ghika, J.-G. Villemure, B. Robert, J. Bogousslavsky, P. R. Burkhard, and F. J.G. Vingerhoets Subthalamic nucleus deep brain stimulation in Parkinson disease patients over age 70 years Neurology, November 23, 2004; 63(10): 1952 - 1954. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Z. Arvanitakis, R. S. Wilson, J. A. Schneider, J. L. Bienias, D. A. Evans, and D. A. Bennett Diabetes mellitus and progression of rigidity and gait disturbance in older persons Neurology, September 28, 2004; 63(6): 996 - 1001. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
A. M. Murray, D. A. Bennett, C. F. Mendes de Leon, L. A. Beckett, and D. A. Evans A Longitudinal Study of Parkinsonism and Disability in a Community Population of Older People J. Gerontol. A Biol. Sci. Med. Sci., August 1, 2004; 59(8): M864 - M870. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. S. Wilson, C. F. Mendes de Leon, J. L. Bienias, D. A. Evans, and D. A. Bennett Personality and Mortality in Old Age J. Gerontol. B. Psychol. Sci. Soc. Sci., May 1, 2004; 59(3): P110 - P116. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. B. Larson, M.-F. Shadlen, L. Wang, W. C. McCormick, J. D. Bowen, L. Teri, and W. A. Kukull Survival after Initial Diagnosis of Alzheimer Disease Ann Intern Med, April 6, 2004; 140(7): 501 - 509. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R. S. Wilson, J. L. Bienias, C. F. Mendes de Leon, D. A. Evans, and D. A. Bennett Negative Affect and Mortality in Older Persons Am. J. Epidemiol., November 1, 2003; 158(9): 827 - 835. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L.L. Barnes, R.S. Wilson, J.A. Schneider, J.L. Bienias, D.A. Evans, and D.A. Bennett Gender, cognitive decline, and risk of AD in older persons Neurology, June 10, 2003; 60(11): 1777 - 1781. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
R. S. Wilson, J. A. Schneider, J. L. Bienias, D. A. Evans, and D. A. Bennett Parkinsonianlike Signs and Risk of Incident Alzheimer Disease in Older Persons Arch Neurol, April 1, 2003; 60(4): 539 - 544. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. Levy, M.-X. Tang, E.D. Louis, L.J. Cote, B. Alfaro, H. Mejia, Y. Stern, and K. Marder The association of incident dementia with mortality in PD Neurology, December 10, 2002; 59(11): 1708 - 1713. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 R S Wilson, J L Bienias, E Berry-Kravis, D A Evans, and D A Bennett The apolipoprotein E {varepsilon}2 allele and decline in episodic memory J. Neurol. Neurosurg. Psychiatry, December 1, 2002; 73(6): 672 - 677. [Abstract] [Full Text] [PDF]
|
|
| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
