期刊
MOVEMENT DISORDERS
卷 25, 期 2, 页码 172-178出版社
WILEY
DOI: 10.1002/mds.22943
关键词
mild parkinsonian signs; population; elderly; epidemiology; incident dementia; Alzheimer's disease
资金
- NIH [AG07232, R01 NS39422, R01 NS42859]
- NIH, NINDS [R01 NS39422, R01 NS42859, R56 NS042859, T32 NS07153-24, R01 NS36630]
- NIH, NIA [2P01 AG0027232-16]
There is some evidence that mild parkinsonian signs (MPSs) are associated with increased risk of dementia, suggesting that MPS could be an early biomarker for dementia. Our aims, in a new cohort, were to determine whether (1) baseline MPS are a predictor of incident dementia and (2) there is an interaction between MPS and other baseline risk factors for dementia (i.e., the presence of both together greatly elevates the risk of dementia) was the objective. In a prospective, longitudinal study of community-dwelling elders in northern Manhattan, NY, Parkinsonian signs were rated with an abbreviated Unified Parkinson's Disease Rating Scale. Risk of incident dementia was assessed using Cox proportional hazards models. There were 1,851 participants (mean follow-up = 3.7 years). Participants with baseline MPS were twice as likely to develop dementia as participants without MPS: 16.3% versus 7.7%, unadjusted hazards ratio (HR) = 2.24 (P < 0.001), adjusted HR = 1.98 (P < 0.001). MPS were divided into three subtypes: adjusted HRaxial dysfunction = 2.45 (P < 0.001), adjusted HRtremor = 2.38 (P = 0.006), and adjusted HRrigidity = 1.16 (P = 0.58). When MPS were treated as a continuous variable, the adjusted HR = 1.15 (P = 0.001). There were no interactions between MPS and other baseline risk factors for dementia, including gender, education, race, family history of dementia, stroke, and apolipoprotein E-e4. Baseline MPS seems to be a predictor of incident dementia. These motor signs might, therefore, serve as a useful biomarker for emerging dementia. (C) 2010 Movement Disorder Society
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