Changes in motor subtype and risk for incident dementia in Parkinson's disease
Identifieur interne : 001B88 ( PascalFrancis/Checkpoint ); précédent : 001B87; suivant : 001B89Changes in motor subtype and risk for incident dementia in Parkinson's disease
Auteurs : Guido Alves [Norvège] ; Jan Petter Larsen [Norvège] ; Murat Emre [Turquie] ; Tore Wentzel-Larsen [Norvège] ; Dag Aarsland [Norvège]Source :
- Movement disorders [ 0885-3185 ] ; 2006.
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Abstract
The objective of this study was to assess the temporal relationship between changes in predominant motor symptoms and incident dementia in Parkinson's disease (PD). A community-based sample of 171 nondemented patients with PD was followed prospectively and examined at baseline and after 4 and 8 years. The motor subtype of Parkinsonism was classified into tremor-dominant (TD), indeterminate, or postural instability gait difficulty (PIGD) subtype at each visit, based on defined items in the Unified Parkinson's Disease Rating Scale, subscales II and III. Dementia was diagnosed according to DSM-III-R criteria, based on clinical interview, cognitive rating scales, and neuropsychological examination. Logistic regression was used to analyze the relationship between subtype of Parkinsonism and dementia. Transition from TD to PIGD subtype was associated with a more than threefold increase in the rate of Mini-Mental State Examination decline. Compared to patients with persistent TD or indeterminate subtype, the odds ratio for dementia was 56.7 (95% CI: 4.0- 808.4; P = 0.003) for patients changing from TD or indeterminate subtype to PIGD subtype, and 80.0 (95% CI: 4.6-1400.1; P = 0.003) for patients with persistent PIGD subtype. Patients with TD subtype at baseline did not become demented until they developed PIGD subtype, and dementia did not occur among patients with persistent TD subtype of Parkinsonism. In a substantial proportion of PD patients who develop postural instability and gait disorder during the course of the disease, this transition is associated with accelerated cognitive decline and highly increased risk for subsequent dementia. These findings raise the question whether PIGD and dementia share common or parallel neuropathology.
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Larsen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>The Norwegian Center for Movement Disorders</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>The Norwegian Center for Movement Disorders</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, Stavanger University Hospital</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>Stavanger</wicri:noRegion></affiliation></author><author><name sortKey="Emre, Murat" sort="Emre, Murat" uniqKey="Emre M" first="Murat" last="Emre">Murat Emre</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Istanbul Faculty of Medicine, Department of Neurology, Istanbul University</s1><s2>Istanbul</s2><s3>TUR</s3><sZ>3 aut.</sZ></inist:fA14><country>Turquie</country><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Wentzel Larsen, Tore" sort="Wentzel Larsen, Tore" uniqKey="Wentzel Larsen T" first="Tore" last="Wentzel-Larsen">Tore Wentzel-Larsen</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Center for Clinical Research, Haukeland University Hospital</s1><s2>Bergen</s2><s3>NOR</s3><sZ>4 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>Bergen</wicri:noRegion></affiliation></author><author><name sortKey="Aarsland, Dag" sort="Aarsland, Dag" uniqKey="Aarsland D" first="Dag" last="Aarsland">Dag Aarsland</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>The Norwegian Center for Movement Disorders</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>The Norwegian Center for Movement Disorders</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Psychiatric Clinic, Stavanger University Hospital</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>5 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>Stavanger</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">INIST</idno><idno type="inist">06-0435080</idno><date when="2006">2006</date><idno type="stanalyst">PASCAL 06-0435080 INIST</idno><idno type="RBID">Pascal:06-0435080</idno><idno type="wicri:Area/PascalFrancis/Corpus">001A58</idno><idno type="wicri:Area/PascalFrancis/Curation">001263</idno><idno type="wicri:Area/PascalFrancis/Checkpoint">001B88</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a">Changes in motor subtype and risk for incident dementia in Parkinson's disease</title><author><name sortKey="Alves, Guido" sort="Alves, Guido" uniqKey="Alves G" first="Guido" last="Alves">Guido Alves</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>The Norwegian Center for Movement Disorders</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>The Norwegian Center for Movement Disorders</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, Stavanger University Hospital</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>Stavanger</wicri:noRegion></affiliation></author><author><name sortKey="Larsen, Jan Petter" sort="Larsen, Jan Petter" uniqKey="Larsen J" first="Jan Petter" last="Larsen">Jan Petter Larsen</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>The Norwegian Center for Movement Disorders</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>The Norwegian Center for Movement Disorders</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="02"><s1>Department of Neurology, Stavanger University Hospital</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>Stavanger</wicri:noRegion></affiliation></author><author><name sortKey="Emre, Murat" sort="Emre, Murat" uniqKey="Emre M" first="Murat" last="Emre">Murat Emre</name><affiliation wicri:level="1"><inist:fA14 i1="03"><s1>Istanbul Faculty of Medicine, Department of Neurology, Istanbul University</s1><s2>Istanbul</s2><s3>TUR</s3><sZ>3 aut.</sZ></inist:fA14><country>Turquie</country><wicri:noRegion>Istanbul</wicri:noRegion></affiliation></author><author><name sortKey="Wentzel Larsen, Tore" sort="Wentzel Larsen, Tore" uniqKey="Wentzel Larsen T" first="Tore" last="Wentzel-Larsen">Tore Wentzel-Larsen</name><affiliation wicri:level="1"><inist:fA14 i1="04"><s1>Center for Clinical Research, Haukeland University Hospital</s1><s2>Bergen</s2><s3>NOR</s3><sZ>4 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>Bergen</wicri:noRegion></affiliation></author><author><name sortKey="Aarsland, Dag" sort="Aarsland, Dag" uniqKey="Aarsland D" first="Dag" last="Aarsland">Dag Aarsland</name><affiliation wicri:level="1"><inist:fA14 i1="01"><s1>The Norwegian Center for Movement Disorders</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>The Norwegian Center for Movement Disorders</wicri:noRegion></affiliation><affiliation wicri:level="1"><inist:fA14 i1="05"><s1>Psychiatric Clinic, Stavanger University Hospital</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>5 aut.</sZ></inist:fA14><country>Norvège</country><wicri:noRegion>Stavanger</wicri:noRegion></affiliation></author></analytic><series><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno><imprint><date when="2006">2006</date></imprint></series></biblStruct></sourceDesc><seriesStmt><title level="j" type="main">Movement disorders</title><title level="j" type="abbreviated">Mov. disord.</title><idno type="ISSN">0885-3185</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Cognitive disorder</term><term>Dementia</term><term>Gait disorder</term><term>Instability</term><term>Nervous system diseases</term><term>Parkinson disease</term><term>Risk factor</term><term>Subtype</term></keywords><keywords scheme="Pascal" xml:lang="fr"><term>Système nerveux pathologie</term><term>Démence</term><term>Parkinson maladie</term><term>Trouble marche</term><term>Trouble cognition</term><term>Soustype</term><term>Facteur risque</term><term>Instabilité</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">The objective of this study was to assess the temporal relationship between changes in predominant motor symptoms and incident dementia in Parkinson's disease (PD). A community-based sample of 171 nondemented patients with PD was followed prospectively and examined at baseline and after 4 and 8 years. The motor subtype of Parkinsonism was classified into tremor-dominant (TD), indeterminate, or postural instability gait difficulty (PIGD) subtype at each visit, based on defined items in the Unified Parkinson's Disease Rating Scale, subscales II and III. Dementia was diagnosed according to DSM-III-R criteria, based on clinical interview, cognitive rating scales, and neuropsychological examination. Logistic regression was used to analyze the relationship between subtype of Parkinsonism and dementia. Transition from TD to PIGD subtype was associated with a more than threefold increase in the rate of Mini-Mental State Examination decline. Compared to patients with persistent TD or indeterminate subtype, the odds ratio for dementia was 56.7 (95% CI: 4.0- 808.4; P = 0.003) for patients changing from TD or indeterminate subtype to PIGD subtype, and 80.0 (95% CI: 4.6-1400.1; P = 0.003) for patients with persistent PIGD subtype. Patients with TD subtype at baseline did not become demented until they developed PIGD subtype, and dementia did not occur among patients with persistent TD subtype of Parkinsonism. In a substantial proportion of PD patients who develop postural instability and gait disorder during the course of the disease, this transition is associated with accelerated cognitive decline and highly increased risk for subsequent dementia. These findings raise the question whether PIGD and dementia share common or parallel neuropathology.</div></front></TEI><inist><standard h6="B"><pA><fA01 i1="01" i2="1"><s0>0885-3185</s0></fA01><fA03 i2="1"><s0>Mov. disord.</s0></fA03><fA05><s2>21</s2></fA05><fA06><s2>8</s2></fA06><fA08 i1="01" i2="1" l="ENG"><s1>Changes in motor subtype and risk for incident dementia in Parkinson's disease</s1></fA08><fA11 i1="01" i2="1"><s1>ALVES (Guido)</s1></fA11><fA11 i1="02" i2="1"><s1>LARSEN (Jan Petter)</s1></fA11><fA11 i1="03" i2="1"><s1>EMRE (Murat)</s1></fA11><fA11 i1="04" i2="1"><s1>WENTZEL-LARSEN (Tore)</s1></fA11><fA11 i1="05" i2="1"><s1>AARSLAND (Dag)</s1></fA11><fA14 i1="01"><s1>The Norwegian Center for Movement Disorders</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ><sZ>5 aut.</sZ></fA14><fA14 i1="02"><s1>Department of Neurology, Stavanger University Hospital</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>1 aut.</sZ><sZ>2 aut.</sZ></fA14><fA14 i1="03"><s1>Istanbul Faculty of Medicine, Department of Neurology, Istanbul University</s1><s2>Istanbul</s2><s3>TUR</s3><sZ>3 aut.</sZ></fA14><fA14 i1="04"><s1>Center for Clinical Research, Haukeland University Hospital</s1><s2>Bergen</s2><s3>NOR</s3><sZ>4 aut.</sZ></fA14><fA14 i1="05"><s1>Psychiatric Clinic, Stavanger University Hospital</s1><s2>Stavanger</s2><s3>NOR</s3><sZ>5 aut.</sZ></fA14><fA20><s1>1123-1130</s1></fA20><fA21><s1>2006</s1></fA21><fA23 i1="01"><s0>ENG</s0></fA23><fA43 i1="01"><s1>INIST</s1><s2>20953</s2><s5>354000142193570110</s5></fA43><fA44><s0>0000</s0><s1>© 2006 INIST-CNRS. All rights reserved.</s1></fA44><fA45><s0>51 ref.</s0></fA45><fA47 i1="01" i2="1"><s0>06-0435080</s0></fA47><fA60><s1>P</s1></fA60><fA61><s0>A</s0></fA61><fA64 i1="01" i2="1"><s0>Movement disorders</s0></fA64><fA66 i1="01"><s0>USA</s0></fA66><fC01 i1="01" l="ENG"><s0>The objective of this study was to assess the temporal relationship between changes in predominant motor symptoms and incident dementia in Parkinson's disease (PD). A community-based sample of 171 nondemented patients with PD was followed prospectively and examined at baseline and after 4 and 8 years. The motor subtype of Parkinsonism was classified into tremor-dominant (TD), indeterminate, or postural instability gait difficulty (PIGD) subtype at each visit, based on defined items in the Unified Parkinson's Disease Rating Scale, subscales II and III. Dementia was diagnosed according to DSM-III-R criteria, based on clinical interview, cognitive rating scales, and neuropsychological examination. Logistic regression was used to analyze the relationship between subtype of Parkinsonism and dementia. Transition from TD to PIGD subtype was associated with a more than threefold increase in the rate of Mini-Mental State Examination decline. Compared to patients with persistent TD or indeterminate subtype, the odds ratio for dementia was 56.7 (95% CI: 4.0- 808.4; P = 0.003) for patients changing from TD or indeterminate subtype to PIGD subtype, and 80.0 (95% CI: 4.6-1400.1; P = 0.003) for patients with persistent PIGD subtype. Patients with TD subtype at baseline did not become demented until they developed PIGD subtype, and dementia did not occur among patients with persistent TD subtype of Parkinsonism. In a substantial proportion of PD patients who develop postural instability and gait disorder during the course of the disease, this transition is associated with accelerated cognitive decline and highly increased risk for subsequent dementia. These findings raise the question whether PIGD and dementia share common or parallel neuropathology.</s0></fC01><fC02 i1="01" i2="X"><s0>002B17</s0></fC02><fC02 i1="02" i2="X"><s0>002B17G</s0></fC02><fC02 i1="03" i2="X"><s0>002B17A03</s0></fC02><fC03 i1="01" i2="X" l="FRE"><s0>Système nerveux pathologie</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="ENG"><s0>Nervous system diseases</s0><s5>01</s5></fC03><fC03 i1="01" i2="X" l="SPA"><s0>Sistema nervioso patología</s0><s5>01</s5></fC03><fC03 i1="02" i2="X" l="FRE"><s0>Démence</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="ENG"><s0>Dementia</s0><s5>02</s5></fC03><fC03 i1="02" i2="X" l="SPA"><s0>Demencia</s0><s5>02</s5></fC03><fC03 i1="03" i2="X" l="FRE"><s0>Parkinson maladie</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="ENG"><s0>Parkinson disease</s0><s5>03</s5></fC03><fC03 i1="03" i2="X" l="SPA"><s0>Parkinson enfermedad</s0><s5>03</s5></fC03><fC03 i1="04" i2="X" l="FRE"><s0>Trouble marche</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="ENG"><s0>Gait disorder</s0><s5>04</s5></fC03><fC03 i1="04" i2="X" l="SPA"><s0>Trastorno marcha</s0><s5>04</s5></fC03><fC03 i1="05" i2="X" l="FRE"><s0>Trouble cognition</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="ENG"><s0>Cognitive disorder</s0><s5>05</s5></fC03><fC03 i1="05" i2="X" l="SPA"><s0>Trastorno cognitivo</s0><s5>05</s5></fC03><fC03 i1="06" i2="X" l="FRE"><s0>Soustype</s0><s5>09</s5></fC03><fC03 i1="06" i2="X" l="ENG"><s0>Subtype</s0><s5>09</s5></fC03><fC03 i1="06" i2="X" l="SPA"><s0>Subtipo</s0><s5>09</s5></fC03><fC03 i1="07" i2="X" l="FRE"><s0>Facteur risque</s0><s5>10</s5></fC03><fC03 i1="07" i2="X" l="ENG"><s0>Risk factor</s0><s5>10</s5></fC03><fC03 i1="07" i2="X" l="SPA"><s0>Factor riesgo</s0><s5>10</s5></fC03><fC03 i1="08" i2="X" l="FRE"><s0>Instabilité</s0><s5>11</s5></fC03><fC03 i1="08" i2="X" l="ENG"><s0>Instability</s0><s5>11</s5></fC03><fC03 i1="08" i2="X" l="SPA"><s0>Inestabilidad</s0><s5>11</s5></fC03><fC07 i1="01" i2="X" l="FRE"><s0>Encéphale pathologie</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="ENG"><s0>Cerebral disorder</s0><s5>37</s5></fC07><fC07 i1="01" i2="X" l="SPA"><s0>Encéfalo patología</s0><s5>37</s5></fC07><fC07 i1="02" i2="X" l="FRE"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="ENG"><s0>Extrapyramidal syndrome</s0><s5>38</s5></fC07><fC07 i1="02" i2="X" l="SPA"><s0>Extrapiramidal síndrome</s0><s5>38</s5></fC07><fC07 i1="03" i2="X" l="FRE"><s0>Maladie dégénérative</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="ENG"><s0>Degenerative disease</s0><s5>39</s5></fC07><fC07 i1="03" i2="X" l="SPA"><s0>Enfermedad degenerativa</s0><s5>39</s5></fC07><fC07 i1="04" i2="X" l="FRE"><s0>Système nerveux central pathologie</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="ENG"><s0>Central nervous system disease</s0><s5>40</s5></fC07><fC07 i1="04" i2="X" l="SPA"><s0>Sistema nervosio central patología</s0><s5>40</s5></fC07><fN21><s1>289</s1></fN21><fN44 i1="01"><s1>OTO</s1></fN44><fN82><s1>OTO</s1></fN82></pA></standard></inist><affiliations><list><country><li>Norvège</li><li>Turquie</li></country></list><tree><country name="Norvège"><noRegion><name sortKey="Alves, Guido" sort="Alves, Guido" uniqKey="Alves G" first="Guido" last="Alves">Guido Alves</name></noRegion><name sortKey="Aarsland, Dag" sort="Aarsland, Dag" uniqKey="Aarsland D" first="Dag" last="Aarsland">Dag Aarsland</name><name sortKey="Aarsland, Dag" sort="Aarsland, Dag" uniqKey="Aarsland D" first="Dag" last="Aarsland">Dag Aarsland</name><name sortKey="Alves, Guido" sort="Alves, Guido" uniqKey="Alves G" first="Guido" last="Alves">Guido Alves</name><name sortKey="Larsen, Jan Petter" sort="Larsen, Jan Petter" uniqKey="Larsen J" first="Jan Petter" last="Larsen">Jan Petter Larsen</name><name sortKey="Larsen, Jan Petter" sort="Larsen, Jan Petter" uniqKey="Larsen J" first="Jan Petter" last="Larsen">Jan Petter Larsen</name><name sortKey="Wentzel Larsen, Tore" sort="Wentzel Larsen, Tore" uniqKey="Wentzel Larsen T" first="Tore" last="Wentzel-Larsen">Tore Wentzel-Larsen</name></country><country name="Turquie"><noRegion><name sortKey="Emre, Murat" sort="Emre, Murat" uniqKey="Emre M" first="Murat" last="Emre">Murat Emre</name></noRegion></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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