Movement Disorders (revue)

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Mild Parkinsonian Signs are Associated with Lower Olfactory Test Scores in the Community-dwelling Elderly

Identifieur interne : 001F86 ( Ncbi/Merge ); précédent : 001F85; suivant : 001F87

Mild Parkinsonian Signs are Associated with Lower Olfactory Test Scores in the Community-dwelling Elderly

Auteurs : Elan D. Louis [États-Unis] ; Karen Marder [États-Unis] ; Matthias H. Tabert [États-Unis] ; D. P. Devanand [États-Unis]

Source :

RBID : PMC:2679986

English descriptors

Abstract

Background

Mild Parkinsonian signs (MPS, impaired gait, rigidity, bradykinesia, rest tremor) are commonly found during the clinical examination of older people and may be a precursor to Parkinson’s disease (PD) or Alzheimer’s disease (AD). Marked deficits in olfaction occur in PD and AD.

Objective

To determine whether University of Pennsylvania Smell Test (UPSIT) scores were lower in non-demented community-dwelling elderly with vs. without MPS.

Methods

Non-demented persons age ≥65 years without PD in Washington Heights-Inwood, NY were evaluated with an abbreviated motor Unified Parkinson’s Disease Rating Scale and a 40-item UPSIT. Lower UPSIT and higher transformed UPSIT score (square root [UPSIT — 41]) indicated greater olfactory dysfunction.

Results

One-hundred-seventy-seven (16.4%) of 1,078 participants had MPS. Mean UPSIT scores (MPS vs. without MPS) were 24.3±7.1 vs. 26.4±6.8, p< 0.001. In a logistic regression analysis adjusting for age and education, transformed UPSIT score was associated with MPS (OR 1.25, 95% CI 1.04 – 1.52, p = 0.02). In an adjusted logistic regression analysis, participants with higher transformed UPSIT scores (based on a median split) were 1.55 times more likely to have MPS than were those with lower scores (p = 0.01). Within transformed UPSIT score quartiles, the odds of having MPS were 1.0 (reference), 1.35, 2.02, and 2.20 (p < 0.05). The association with transformed UPSIT scores was similar across MPS sub-types (axial dysfunction, rigidity, tremor).

Conclusions

MPS were associated with a mild reduction in olfactory function. These observations further support the view of MPS as a marker of emerging degenerative brain pathologies.


Url:
DOI: 10.1002/mds.21777
PubMed: 18098296
PubMed Central: 2679986

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PMC:2679986

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<keywords scheme="KwdEn" xml:lang="en">
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Dementia (diagnosis)</term>
<term>Dementia (epidemiology)</term>
<term>Diagnosis, Differential</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Movement Disorders (diagnosis)</term>
<term>Movement Disorders (epidemiology)</term>
<term>Olfaction Disorders (diagnosis)</term>
<term>Olfaction Disorders (epidemiology)</term>
<term>Parkinsonian Disorders (diagnosis)</term>
<term>Parkinsonian Disorders (physiopathology)</term>
<term>Prevalence</term>
<term>Residence Characteristics</term>
<term>Severity of Illness Index</term>
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<term>Dementia</term>
<term>Movement Disorders</term>
<term>Olfaction Disorders</term>
<term>Parkinsonian Disorders</term>
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<term>Dementia</term>
<term>Movement Disorders</term>
<term>Olfaction Disorders</term>
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<term>Parkinsonian Disorders</term>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Diagnosis, Differential</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Prevalence</term>
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<div type="abstract" xml:lang="en">
<sec id="S1">
<title>Background</title>
<p id="P1">Mild Parkinsonian signs (MPS, impaired gait, rigidity, bradykinesia, rest tremor) are commonly found during the clinical examination of older people and may be a precursor to Parkinson’s disease (PD) or Alzheimer’s disease (AD). Marked deficits in olfaction occur in PD and AD.</p>
</sec>
<sec id="S2">
<title>Objective</title>
<p id="P2">To determine whether University of Pennsylvania Smell Test (UPSIT) scores were lower in non-demented community-dwelling elderly with vs. without MPS.</p>
</sec>
<sec sec-type="methods" id="S3">
<title>Methods</title>
<p id="P3">Non-demented persons age ≥65 years without PD in Washington Heights-Inwood, NY were evaluated with an abbreviated motor Unified Parkinson’s Disease Rating Scale and a 40-item UPSIT. Lower UPSIT and higher transformed UPSIT score (square root [UPSIT — 41]) indicated greater olfactory dysfunction.</p>
</sec>
<sec id="S4">
<title>Results</title>
<p id="P4">One-hundred-seventy-seven (16.4%) of 1,078 participants had MPS. Mean UPSIT scores (MPS vs. without MPS) were 24.3±7.1 vs. 26.4±6.8, p< 0.001. In a logistic regression analysis adjusting for age and education, transformed UPSIT score was associated with MPS (OR 1.25, 95% CI 1.04 – 1.52, p = 0.02). In an adjusted logistic regression analysis, participants with higher transformed UPSIT scores (based on a median split) were 1.55 times more likely to have MPS than were those with lower scores (p = 0.01). Within transformed UPSIT score quartiles, the odds of having MPS were 1.0 (reference), 1.35, 2.02, and 2.20 (p < 0.05). The association with transformed UPSIT scores was similar across MPS sub-types (axial dysfunction, rigidity, tremor).</p>
</sec>
<sec id="S5">
<title>Conclusions</title>
<p id="P5">MPS were associated with a mild reduction in olfactory function. These observations further support the view of MPS as a marker of emerging degenerative brain pathologies.</p>
</sec>
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<wicri:regionArea>Department of Biological Psychiatry, College of Physicians and Surgeons, Columbia University, New York, N.Y.</wicri:regionArea>
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<wicri:regionArea>New York State Psychiatric Institute, New York, N.Y.</wicri:regionArea>
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<title xml:lang="en" level="a" type="main">Mild Parkinsonian Signs are Associated with Lower Olfactory Test Scores in the Community-dwelling Elderly</title>
<author>
<name sortKey="Louis, Elan D" sort="Louis, Elan D" uniqKey="Louis E" first="Elan D." last="Louis">Elan D. Louis</name>
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<nlm:aff id="A1">The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, N.Y., U.S.A.</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, N.Y.</wicri:regionArea>
<orgName type="university">Université Columbia</orgName>
<placeName>
<settlement type="city">New York</settlement>
<region type="state">État de New York</region>
</placeName>
</affiliation>
<affiliation wicri:level="4">
<nlm:aff id="A2">Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, N.Y., U.S.A.</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, N.Y.</wicri:regionArea>
<orgName type="university">Université Columbia</orgName>
<placeName>
<settlement type="city">New York</settlement>
<region type="state">État de New York</region>
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<nlm:aff id="A3">Taub Institute for Research of Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, N.Y., U.S.A.</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Taub Institute for Research of Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, N.Y.</wicri:regionArea>
<orgName type="university">Université Columbia</orgName>
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<settlement type="city">New York</settlement>
<region type="state">État de New York</region>
</placeName>
</affiliation>
<affiliation wicri:level="4">
<nlm:aff id="A6">Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, N.Y., U.S.A.</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, N.Y.</wicri:regionArea>
<orgName type="university">Université Columbia</orgName>
<placeName>
<settlement type="city">New York</settlement>
<region type="state">État de New York</region>
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</author>
<author>
<name sortKey="Marder, Karen" sort="Marder, Karen" uniqKey="Marder K" first="Karen" last="Marder">Karen Marder</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, N.Y.</wicri:regionArea>
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<settlement type="city">New York</settlement>
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<wicri:regionArea>Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, N.Y.</wicri:regionArea>
<orgName type="university">Université Columbia</orgName>
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<settlement type="city">New York</settlement>
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<nlm:aff id="A3">Taub Institute for Research of Alzheimer’s Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, N.Y., U.S.A.</nlm:aff>
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<placeName>
<settlement type="city">New York</settlement>
<region type="state">État de New York</region>
</placeName>
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<author>
<name sortKey="Tabert, Matthias H" sort="Tabert, Matthias H" uniqKey="Tabert M" first="Matthias H." last="Tabert">Matthias H. Tabert</name>
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<nlm:aff id="A4">Department of Geriatric Psychiatry, College of Physicians and Surgeons, Columbia University, New York, N.Y., U.S.A.</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Geriatric Psychiatry, College of Physicians and Surgeons, Columbia University, New York, N.Y.</wicri:regionArea>
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<settlement type="city">New York</settlement>
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<wicri:regionArea>New York State Psychiatric Institute, New York, N.Y.</wicri:regionArea>
<wicri:noRegion>N.Y.</wicri:noRegion>
</affiliation>
</author>
<author>
<name sortKey="Devanand, D P" sort="Devanand, D P" uniqKey="Devanand D" first="D. P." last="Devanand">D. P. Devanand</name>
<affiliation wicri:level="4">
<nlm:aff id="A5">Department of Biological Psychiatry, College of Physicians and Surgeons, Columbia University, New York, N.Y., U.S.A.</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Biological Psychiatry, College of Physicians and Surgeons, Columbia University, New York, N.Y.</wicri:regionArea>
<orgName type="university">Université Columbia</orgName>
<placeName>
<settlement type="city">New York</settlement>
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<nlm:aff id="A7">New York State Psychiatric Institute, New York, N.Y., U.S.A.</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>New York State Psychiatric Institute, New York, N.Y.</wicri:regionArea>
<wicri:noRegion>N.Y.</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series>
<title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
<idno type="ISSN">0885-3185</idno>
<idno type="eISSN">1531-8257</idno>
<imprint>
<date when="2008">2008</date>
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<div type="abstract" xml:lang="en">
<sec id="S1">
<title>Background</title>
<p id="P1">Mild Parkinsonian signs (MPS, impaired gait, rigidity, bradykinesia, rest tremor) are commonly found during the clinical examination of older people and may be a precursor to Parkinson’s disease (PD) or Alzheimer’s disease (AD). Marked deficits in olfaction occur in PD and AD.</p>
</sec>
<sec id="S2">
<title>Objective</title>
<p id="P2">To determine whether University of Pennsylvania Smell Test (UPSIT) scores were lower in non-demented community-dwelling elderly with vs. without MPS.</p>
</sec>
<sec sec-type="methods" id="S3">
<title>Methods</title>
<p id="P3">Non-demented persons age ≥65 years without PD in Washington Heights-Inwood, NY were evaluated with an abbreviated motor Unified Parkinson’s Disease Rating Scale and a 40-item UPSIT. Lower UPSIT and higher transformed UPSIT score (square root [UPSIT — 41]) indicated greater olfactory dysfunction.</p>
</sec>
<sec id="S4">
<title>Results</title>
<p id="P4">One-hundred-seventy-seven (16.4%) of 1,078 participants had MPS. Mean UPSIT scores (MPS vs. without MPS) were 24.3±7.1 vs. 26.4±6.8, p< 0.001. In a logistic regression analysis adjusting for age and education, transformed UPSIT score was associated with MPS (OR 1.25, 95% CI 1.04 – 1.52, p = 0.02). In an adjusted logistic regression analysis, participants with higher transformed UPSIT scores (based on a median split) were 1.55 times more likely to have MPS than were those with lower scores (p = 0.01). Within transformed UPSIT score quartiles, the odds of having MPS were 1.0 (reference), 1.35, 2.02, and 2.20 (p < 0.05). The association with transformed UPSIT scores was similar across MPS sub-types (axial dysfunction, rigidity, tremor).</p>
</sec>
<sec id="S5">
<title>Conclusions</title>
<p id="P5">MPS were associated with a mild reduction in olfactory function. These observations further support the view of MPS as a marker of emerging degenerative brain pathologies.</p>
</sec>
</div>
</front>
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<nlm:affiliation>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA. edl2@columbia.edu</nlm:affiliation>
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<name sortKey="Marder, Karen" sort="Marder, Karen" uniqKey="Marder K" first="Karen" last="Marder">Karen Marder</name>
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<name sortKey="Tabert, Matthias H" sort="Tabert, Matthias H" uniqKey="Tabert M" first="Matthias H" last="Tabert">Matthias H. Tabert</name>
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<name sortKey="Devanand, Devangere P" sort="Devanand, Devangere P" uniqKey="Devanand D" first="Devangere P" last="Devanand">Devangere P. Devanand</name>
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<nlm:affiliation>The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA. edl2@columbia.edu</nlm:affiliation>
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<name sortKey="Marder, Karen" sort="Marder, Karen" uniqKey="Marder K" first="Karen" last="Marder">Karen Marder</name>
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<name sortKey="Tabert, Matthias H" sort="Tabert, Matthias H" uniqKey="Tabert M" first="Matthias H" last="Tabert">Matthias H. Tabert</name>
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<name sortKey="Devanand, Devangere P" sort="Devanand, Devangere P" uniqKey="Devanand D" first="Devangere P" last="Devanand">Devangere P. Devanand</name>
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<term>Aged, 80 and over</term>
<term>Dementia (diagnosis)</term>
<term>Dementia (epidemiology)</term>
<term>Diagnosis, Differential</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Movement Disorders (diagnosis)</term>
<term>Movement Disorders (epidemiology)</term>
<term>Olfaction Disorders (diagnosis)</term>
<term>Olfaction Disorders (epidemiology)</term>
<term>Parkinsonian Disorders (diagnosis)</term>
<term>Parkinsonian Disorders (physiopathology)</term>
<term>Prevalence</term>
<term>Residence Characteristics</term>
<term>Severity of Illness Index</term>
</keywords>
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<term>Dementia</term>
<term>Movement Disorders</term>
<term>Olfaction Disorders</term>
<term>Parkinsonian Disorders</term>
</keywords>
<keywords scheme="MESH" qualifier="epidemiology" xml:lang="en">
<term>Dementia</term>
<term>Movement Disorders</term>
<term>Olfaction Disorders</term>
</keywords>
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<term>Parkinsonian Disorders</term>
</keywords>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Diagnosis, Differential</term>
<term>Female</term>
<term>Follow-Up Studies</term>
<term>Humans</term>
<term>Male</term>
<term>Prevalence</term>
<term>Residence Characteristics</term>
<term>Severity of Illness Index</term>
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<front>
<div type="abstract" xml:lang="en">Mild Parkinsonian signs (MPS, impaired gait, rigidity, bradykinesia, rest tremor) are commonly found during the clinical examination of older people and may be a precursor to Parkinson's disease (PD) or Alzheimer's disease (AD). Marked deficits in olfaction occur in PD and AD. The objective of this study was to determine whether University of Pennsylvania Smell Test (UPSIT) scores were lower in nondemented community-dwelling elderly with versus without MPS. Nondemented persons age >or=65 years without PD in Washington Heights-Inwood, NY were evaluated with an abbreviated motor Unified PD Rating Scale and a 40-item UPSIT. Lower UPSIT and higher transformed UPSIT score (square root [UPSIT - 41]) indicated greater olfactory dysfunction. One-hundred-seventy-seven (16.4%) of 1,078 participants had MPS. Mean UPSIT scores (MPS vs. without MPS) were 24.3 +/- 7.1 versus 26.4 +/- 6.8, P < 0.001. In a logistic regression analysis adjusting for age and education, transformed UPSIT score was associated with MPS (OR 1.25, 95% CI 1.04-1.52, P = 0.02). In an adjusted logistic regression analysis, participants with higher transformed UPSIT scores (based on a median split) were 1.55 times more likely to have MPS than were those with lower scores (P = 0.01). Within transformed UPSIT score quartiles, the odds of having MPS were 1.0 (reference), 1.35, 2.02, and 2.20 (P < 0.05). The association with transformed UPSIT scores was similar across MPS subtypes (axial dysfunction, rigidity, tremor).MPS were associated with a mild reduction in olfactory function. These observations further support the view of MPS as a marker of emerging degenerative brain pathologies.</div>
</front>
</TEI>
</pubmed>
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