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The evolution of mild parkinsonian signs in aging

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Abstract

The progression of mild parkinsonian signs in the absence of idiopathic Parkinson’s disease in aging is unclear. This study aims to identify predictors of the evolution of mild parkinsonian signs in non-demented older adults. Two hundred ten participants (76.25 ± 7.10 years, 57 % women) were assessed at baseline and 1-year follow-up. Mild parkinsonian signs were defined as the presence of bradykinesia, rigidity and/or rest tremor. Depending upon the presence of these features at baseline and follow-up, participants were divided into one of four groups (no, transient, persistent or new-onset mild parkinsonian signs). Physical function was assessed using gait velocity. Ninety-five participants presented with mild parkinsonian signs at baseline. At 1-year follow-up, 59 demonstrated persistent mild parkinsonian signs, while 36 recovered (i.e., transient). Participants with persistent mild parkinsonian signs were older (79.66 ± 7.15 vs. 75.81 ± 7.37 years, p = 0.01) and evidenced slower gait velocity (90.41 ± 21.46 vs. 109.92 ± 24.32 cm/s, p < 0.01) compared to those with transient mild parkinsonian signs. Gait velocity predicted persistence of mild parkinsonian signs, even after adjustments (OR: 0.96, 95 % CI: 0.94–0.98). Fifty-five participants demonstrated new-onset of mild parkinsonian signs. In comparison to participants without mild parkinsonian signs, presence of cardiovascular but not cerebrovascular disease at baseline was associated with new-onset mild parkinsonian signs. Our study reveals that gait velocity was the main predictor of persistent mild parkinsonian signs, whereas cardiovascular disease was associated with new-onset mild parkinsonian signs. These findings suggest a vascular mechanism for the onset of mild parkinsonian signs and a different mechanism, possibly neurodegenerative, for the persistence of mild parkinsonian signs.

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Acknowledgments

Research was supported by funding from the National Institute on Aging (R01AG036921-01A1 & R01AG044007-01A1). Special thanks to all of the CCMA research assistants for their assistance with data collection.

Conflicts of interest

No competing interests to report.

Funding

This study was supported by funds from the National Institutes of Health, National Institute on Aging (R01AG036921-01A1 & R01AG044007-01A1). Gilles Allali is supported by a Grant from the Geneva University Hospitals.

Ethical standards

The institutional review board of the Albert Einstein College of Medicine approved the experimental procedures and all participants provided written informed consent in accordance with the tenets of the Declaration of Helsinki.

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Authors and Affiliations

  1. Department of Neurology, Division of Cognitive and Motor Aging, Albert Einstein College of Medicine, Yeshiva University, 1165 Morris Park Avenue, Room 325, Bronx, New York, 10461, USA

    Jeannette R. Mahoney, Joe Verghese, Roee Holtzer & Gilles Allali

  2. Ferkauf Graduate of Psychology, Yeshiva University, Bronx, New York, USA

    Roee Holtzer

  3. Department of Clinical Neurosciences, Geneva University Hospitals and University of Geneva, Geneva, Switzerland

    Gilles Allali

Authors
  1. Jeannette R. Mahoney
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  2. Joe Verghese
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  3. Roee Holtzer
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  4. Gilles Allali
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Corresponding author

Correspondence to Gilles Allali.

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Mahoney, J.R., Verghese, J., Holtzer, R. et al. The evolution of mild parkinsonian signs in aging. J Neurol 261, 1922–1928 (2014). https://doi.org/10.1007/s00415-014-7442-4

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  • DOI: https://doi.org/10.1007/s00415-014-7442-4

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