Year: 2016
Type: article
Study design: Observational Study
Abstract: 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. CONCLUSIONS: Parkinsonism is common in older adults and increases with age. Identifying modifiable risk factors may decrease the magnitude of this growing public health problem.
Source: Neurology
Authors: Aron S. Buchman, Sue E. Leurgans, Lei Yu, Robert S. Wilson, Andrew S. Lim, Bryan D. James, Joshua M. Shulman, David A. Bennett
Language: English
Subfield: Clinical Neurology
Field: Medicine
Domain: Health Sciences
Open Access status: bronze
Awards: Brain and Spinal Cord Microvascular Pathology in Late-Life Motor Impairment, Epidemiologic Study of Neural Reserve and Neurobiology of Aging, G1827704456, Rush Center of Excellence on Disparties in HIV and Aging (CEDHA), Epidemiologic Study of TDP-43 Pathology in Aging and Dementia, Pathway discovery, validation and compound identification for Alzheimer's disease, Cognitive decline after hospitalization in older adults: predictors and pathogenesis, Exploring the Genetics of Alzheimer's Disease in Humans and Drosophila, Exploring the Role of the Brain Epigenome: Cognitive Decline and Life Experiences, Plasticity circuits in Alzheimer s disease, Risk Factors, Pathology, and Clinical Expressions of AD, The Clinical Profile of Parkinson's Disease (PD) Pathology, Rush Alzheimer's Disease Core Center, Alzheimer's Disease Genetics Consortium, Vascular Cognitive and Motor Decline: Impact of aPL, Spinal cord and brainstem pathology contributions to late-life gait impairment, Functional Validation of Parkinsons Disease Susceptibility Genes in Drosophila, Discovery of Novel Proteomic Targets for Treatment of Alzheimer's Disease, Role of impaired cognitive states & risk factors in conversion to mixed dementias, AD Gene Discovery: Exome Chip, New Endophenotypes & Functional Studies in CHARGE, Risk Factors, Pathology, and Clinical Expressions of AD, Development of Lewy Bodies Biofluid Signatures by Targeted Proteomics, Epidemiologic Study of Decision Making in Preclinical Alzheimer's Disease, Characterizing the Behavior Profile of Healthy Cognitive Aging, Racial Differences in Late-Life Cognitive decline and risk of Alzheimer's Disease
OpenAlex ID: W2504196224