Combined effect of age and severity on the risk of dementia in Parkinson's disease
Identifieur interne : 000269 ( Main/Corpus ); précédent : 000268; suivant : 000270Combined effect of age and severity on the risk of dementia in Parkinson's disease
Auteurs : Gilberto Levy ; Nicole Schupf ; Ming-Xin Tang ; Lucien J. Cote ; Elan D. Louis ; Helen Mejia ; Yaakov Stern ; Karen MarderSource :
- Annals of Neurology [ 0364-5134 ] ; 2002-06.
Abstract
Age and severity of extrapyramidal signs have been consistently associated with incident dementia in Parkinson's disease. We evaluated the separate and combined effects of age and severity of extrapyramidal signs on the risk of incident dementia in Parkinson's disease in the setting of a population‐based prospective cohort study. Age and the total Unified Parkinson's Disease Rating Scale motor score at baseline evaluation were dichotomized at the median. Four groups of Parkinson's disease patients were defined: younger age/low severity (reference), younger age/high severity, older age/low severity, and older age/high severity. Risk ratios for incident dementia were calculated with Cox proportional hazards models controlling for gender, education, ethnicity, and duration of Parkinson's disease. Of 180 patients, 52 (28.9%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. The median age at baseline of the Parkinson's disease patients was 71.8 years (range, 38.5–95.9 years), and the median total Unified Parkinson's Disease Rating Scale motor score was 24 (range, 2–65). The group with older age/high severity had a significantly increased risk of incident dementia (relative risk, 9.7; 95% confidence interval, 3.9–24.4) compared with the group with younger age/low severity (reference), whereas the groups with older age/low severity (relative risk, 1.6; 95% confidence interval, 0.5–4.8) and younger age/high severity (relative risk, 1.2; 95% confidence interval, 0.5–3.2) did not. These findings suggest that the increased risk of incident dementia in Parkinson's disease associated with age and severity of extrapyramidal signs is related primarily to their combined effect rather than separate effects.
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DOI: 10.1002/ana.10219
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We evaluated the separate and combined effects of age and severity of extrapyramidal signs on the risk of incident dementia in Parkinson's disease in the setting of a population‐based prospective cohort study. Age and the total Unified Parkinson's Disease Rating Scale motor score at baseline evaluation were dichotomized at the median. Four groups of Parkinson's disease patients were defined: younger age/low severity (reference), younger age/high severity, older age/low severity, and older age/high severity. Risk ratios for incident dementia were calculated with Cox proportional hazards models controlling for gender, education, ethnicity, and duration of Parkinson's disease. Of 180 patients, 52 (28.9%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. The median age at baseline of the Parkinson's disease patients was 71.8 years (range, 38.5–95.9 years), and the median total Unified Parkinson's Disease Rating Scale motor score was 24 (range, 2–65). The group with older age/high severity had a significantly increased risk of incident dementia (relative risk, 9.7; 95% confidence interval, 3.9–24.4) compared with the group with younger age/low severity (reference), whereas the groups with older age/low severity (relative risk, 1.6; 95% confidence interval, 0.5–4.8) and younger age/high severity (relative risk, 1.2; 95% confidence interval, 0.5–3.2) did not. These findings suggest that the increased risk of incident dementia in Parkinson's disease associated with age and severity of extrapyramidal signs is related primarily to their combined effect rather than separate effects.</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>Gilberto Levy MD</name><affiliations><json:string>Gertrude H. Sergievsky Center and</json:string></affiliations></json:item><json:item><name>Nicole Schupf PhD</name><affiliations><json:string>Gertrude H. 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Sergievsky Center and</json:string><json:string>Neurology and</json:string></affiliations></json:item><json:item><name>Helen Mejia MA</name><affiliations><json:string>Gertrude H. Sergievsky Center and</json:string><json:string>Neurology and</json:string></affiliations></json:item><json:item><name>Yaakov Stern PhD</name><affiliations><json:string>Gertrude H. Sergievsky Center and</json:string><json:string>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY</json:string><json:string>Neurology and</json:string><json:string>Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY</json:string></affiliations></json:item><json:item><name>Karen Marder MD, MPH</name><affiliations><json:string>Gertrude H. Sergievsky Center and</json:string><json:string>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY</json:string><json:string>Neurology and</json:string></affiliations></json:item></author><articleId><json:string>ANA10219</json:string></articleId><language><json:string>eng</json:string></language><abstract>Age and severity of extrapyramidal signs have been consistently associated with incident dementia in Parkinson's disease. We evaluated the separate and combined effects of age and severity of extrapyramidal signs on the risk of incident dementia in Parkinson's disease in the setting of a population‐based prospective cohort study. Age and the total Unified Parkinson's Disease Rating Scale motor score at baseline evaluation were dichotomized at the median. Four groups of Parkinson's disease patients were defined: younger age/low severity (reference), younger age/high severity, older age/low severity, and older age/high severity. Risk ratios for incident dementia were calculated with Cox proportional hazards models controlling for gender, education, ethnicity, and duration of Parkinson's disease. Of 180 patients, 52 (28.9%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. The median age at baseline of the Parkinson's disease patients was 71.8 years (range, 38.5–95.9 years), and the median total Unified Parkinson's Disease Rating Scale motor score was 24 (range, 2–65). The group with older age/high severity had a significantly increased risk of incident dementia (relative risk, 9.7; 95% confidence interval, 3.9–24.4) compared with the group with younger age/low severity (reference), whereas the groups with older age/low severity (relative risk, 1.6; 95% confidence interval, 0.5–4.8) and younger age/high severity (relative risk, 1.2; 95% confidence interval, 0.5–3.2) did not. These findings suggest that the increased risk of incident dementia in Parkinson's disease associated with age and severity of extrapyramidal signs is related primarily to their combined effect rather than separate effects.</abstract><qualityIndicators><score>7.976</score><pdfVersion>1.2</pdfVersion><pdfPageSize>605 x 786 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1737</abstractCharCount><pdfWordCount>5546</pdfWordCount><pdfCharCount>34836</pdfCharCount><pdfPageCount>8</pdfPageCount><abstractWordCount>248</abstractWordCount></qualityIndicators><title>Combined effect of age and severity on the risk of dementia in Parkinson's disease</title><genre><json:string>article</json:string></genre><host><volume>51</volume><publisherId><json:string>ANA</json:string></publisherId><pages><total>8</total><last>729</last><first>722</first></pages><issn><json:string>0364-5134</json:string></issn><issue>6</issue><subject><json:item><value>Original Articles</value></json:item></subject><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1531-8249</json:string></eissn><title>Annals of Neurology</title><doi><json:string>10.1002/(ISSN)1531-8249</json:string></doi></host><publicationDate>2002</publicationDate><copyrightDate>2002</copyrightDate><doi><json:string>10.1002/ana.10219</json:string></doi><id>B0F2FEFEFB359DABFA83451D564B46A62585A378</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/B0F2FEFEFB359DABFA83451D564B46A62585A378/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/B0F2FEFEFB359DABFA83451D564B46A62585A378/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/B0F2FEFEFB359DABFA83451D564B46A62585A378/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Combined effect of age and severity on the risk of dementia in Parkinson's disease</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><availability><p>WILEY</p></availability><date>2002</date></publicationStmt><notesStmt><note>federal grants - No. AG10963 (K.M., H.M.); No. AG07232 (K.M., Y.S.); No. RR00645 (K.M.); No. NS36630 (K.M., E.L., G.L.);</note><note>Parkinson's Disease Foundation - No. 611406 (K.M., Y.S., H.M.);</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Combined effect of age and severity on the risk of dementia in Parkinson's disease</title><author><persName><forename type="first">Gilberto</forename><surname>Levy</surname></persName><roleName type="degree">MD</roleName><affiliation>Gertrude H. 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Sergievsky Center and</affiliation><affiliation>Neurology and</affiliation></author><author><persName><forename type="first">Yaakov</forename><surname>Stern</surname></persName><roleName type="degree">PhD</roleName><affiliation>Gertrude H. Sergievsky Center and</affiliation><affiliation>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY</affiliation><affiliation>Neurology and</affiliation><affiliation>Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY</affiliation></author><author><persName><forename type="first">Karen</forename><surname>Marder</surname></persName><roleName type="degree">MD, MPH</roleName><note type="correspondence"><p>Correspondence: Gertrude H. Sergievsky Center, 630 West 168th Street, New York, NY 10032</p></note><affiliation>Gertrude H. Sergievsky Center and</affiliation><affiliation>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY</affiliation><affiliation>Neurology and</affiliation></author></analytic><monogr><title level="j">Annals of Neurology</title><title level="j" type="sub">Official Journal of the American Neurological Association and the Child Neurology Society</title><title level="j" type="abbrev">Ann Neurol.</title><idno type="pISSN">0364-5134</idno><idno type="eISSN">1531-8249</idno><idno type="DOI">10.1002/(ISSN)1531-8249</idno><imprint><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><pubPlace>New York</pubPlace><date type="published" when="2002-06"></date><biblScope unit="volume">51</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="722">722</biblScope><biblScope unit="page" to="729">729</biblScope></imprint></monogr><idno type="istex">B0F2FEFEFB359DABFA83451D564B46A62585A378</idno><idno type="DOI">10.1002/ana.10219</idno><idno type="ArticleID">ANA10219</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>2002</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Age and severity of extrapyramidal signs have been consistently associated with incident dementia in Parkinson's disease. We evaluated the separate and combined effects of age and severity of extrapyramidal signs on the risk of incident dementia in Parkinson's disease in the setting of a population‐based prospective cohort study. Age and the total Unified Parkinson's Disease Rating Scale motor score at baseline evaluation were dichotomized at the median. Four groups of Parkinson's disease patients were defined: younger age/low severity (reference), younger age/high severity, older age/low severity, and older age/high severity. Risk ratios for incident dementia were calculated with Cox proportional hazards models controlling for gender, education, ethnicity, and duration of Parkinson's disease. Of 180 patients, 52 (28.9%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. The median age at baseline of the Parkinson's disease patients was 71.8 years (range, 38.5–95.9 years), and the median total Unified Parkinson's Disease Rating Scale motor score was 24 (range, 2–65). The group with older age/high severity had a significantly increased risk of incident dementia (relative risk, 9.7; 95% confidence interval, 3.9–24.4) compared with the group with younger age/low severity (reference), whereas the groups with older age/low severity (relative risk, 1.6; 95% confidence interval, 0.5–4.8) and younger age/high severity (relative risk, 1.2; 95% confidence interval, 0.5–3.2) did not. These findings suggest that the increased risk of incident dementia in Parkinson's disease associated with age and severity of extrapyramidal signs is related primarily to their combined effect rather than separate effects.</p></abstract><textClass><keywords scheme="Journal Subject"><list><head>article category</head><item><term>Original Articles</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="2001-11-26">Received</change><change when="2002-02-22">Registration</change><change when="2002-06">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/B0F2FEFEFB359DABFA83451D564B46A62585A378/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Wiley Subscription Services, Inc., A Wiley Company</publisherName><publisherLoc>New York</publisherLoc></publisherInfo><doi registered="yes">10.1002/(ISSN)1531-8249</doi><issn type="print">0364-5134</issn><issn type="electronic">1531-8249</issn><idGroup><id type="product" value="ANA"></id></idGroup><titleGroup><title type="main" xml:lang="en" sort="ANNALS OF NEUROLOGY">Annals of Neurology</title><title type="subtitle">Official Journal of the American Neurological Association and the Child Neurology Society</title><title type="short">Ann Neurol.</title></titleGroup></publicationMeta><publicationMeta level="part" position="60"><doi origin="wiley" registered="yes">10.1002/ana.v51:6</doi><numberingGroup><numbering type="journalVolume" number="51">51</numbering><numbering type="journalIssue">6</numbering></numberingGroup><coverDate startDate="2002-06">June 2002</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="10" status="forIssue"><doi origin="wiley" registered="yes">10.1002/ana.10219</doi><idGroup><id type="unit" value="ANA10219"></id></idGroup><countGroup><count type="pageTotal" number="8"></count></countGroup><titleGroup><title type="articleCategory">Original Articles</title><title type="tocHeading1">Original Articles</title></titleGroup><copyright ownership="publisher">Copyright © 2002 Wiley‐Liss, Inc.</copyright><eventGroup><event type="manuscriptReceived" date="2001-11-26"></event><event type="manuscriptRevised" date="2002-02-20"></event><event type="manuscriptAccepted" date="2002-02-22"></event><event type="firstOnline" date="2002-05-21"></event><event type="publishedOnlineFinalForm" date="2002-05-21"></event><event type="xmlConverted" agent="Converter:JWSART34_TO_WML3G version:2.3.1 mode:FullText source:FullText result:FullText" date="2010-02-23"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-01-03"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-10-14"></event></eventGroup><numberingGroup><numbering type="pageFirst">722</numbering><numbering type="pageLast">729</numbering></numberingGroup><correspondenceTo>Gertrude H. Sergievsky Center, 630 West 168th Street, New York, NY 10032</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:ANA.ANA10219.pdf"></link></linkGroup></publicationMeta><contentMeta><countGroup><count type="figureTotal" number="1"></count><count type="tableTotal" number="5"></count><count type="referenceTotal" number="57"></count><count type="wordTotal" number="6370"></count></countGroup><titleGroup><title type="main" xml:lang="en">Combined effect of age and severity on the risk of dementia in Parkinson's disease</title><title type="short" xml:lang="en">Dementia in Parkinson's disease</title></titleGroup><creators><creator xml:id="au1" creatorRole="author" affiliationRef="#af1"><personName><givenNames>Gilberto</givenNames><familyName>Levy</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au2" creatorRole="author" affiliationRef="#af1 #af2 #af3"><personName><givenNames>Nicole</givenNames><familyName>Schupf</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au3" creatorRole="author" affiliationRef="#af1 #af2 #af4"><personName><givenNames>Ming‐Xin</givenNames><familyName>Tang</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au4" creatorRole="author" affiliationRef="#af5"><personName><givenNames>Lucien J.</givenNames><familyName>Cote</familyName><degrees>MD</degrees></personName></creator><creator xml:id="au5" creatorRole="author" affiliationRef="#af1 #af5"><personName><givenNames>Elan D.</givenNames><familyName>Louis</familyName><degrees>MD, MS</degrees></personName></creator><creator xml:id="au6" creatorRole="author" affiliationRef="#af1 #af5"><personName><givenNames>Helen</givenNames><familyName>Mejia</familyName><degrees>MA</degrees></personName></creator><creator xml:id="au7" creatorRole="author" affiliationRef="#af1 #af2 #af5 #af6"><personName><givenNames>Yaakov</givenNames><familyName>Stern</familyName><degrees>PhD</degrees></personName></creator><creator xml:id="au8" creatorRole="author" affiliationRef="#af1 #af2 #af5" corresponding="yes"><personName><givenNames>Karen</givenNames><familyName>Marder</familyName><degrees>MD, MPH</degrees></personName><contactDetails><email>marderk@sergievsky.cpmc.columbia.edu</email></contactDetails></creator></creators><affiliationGroup><affiliation xml:id="af1" countryCode="US" type="organization"><unparsedAffiliation>Gertrude H. Sergievsky Center and</unparsedAffiliation></affiliation><affiliation xml:id="af2" countryCode="US" type="organization"><unparsedAffiliation>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY</unparsedAffiliation></affiliation><affiliation xml:id="af3" countryCode="US" type="organization"><unparsedAffiliation>New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY</unparsedAffiliation></affiliation><affiliation xml:id="af4" countryCode="US" type="organization"><unparsedAffiliation>Division of Biostatistics, School of Public Health Departments of</unparsedAffiliation></affiliation><affiliation xml:id="af5" countryCode="US" type="organization"><unparsedAffiliation>Neurology and</unparsedAffiliation></affiliation><affiliation xml:id="af6" countryCode="US" type="organization"><unparsedAffiliation>Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY</unparsedAffiliation></affiliation></affiliationGroup><fundingInfo><fundingAgency>federal grants</fundingAgency><fundingNumber>AG10963 (K.M., H.M.)</fundingNumber><fundingNumber>AG07232 (K.M., Y.S.)</fundingNumber><fundingNumber>RR00645 (K.M.)</fundingNumber><fundingNumber>NS36630 (K.M., E.L., G.L.)</fundingNumber></fundingInfo><fundingInfo><fundingAgency>Parkinson's Disease Foundation</fundingAgency><fundingNumber>611406 (K.M., Y.S., H.M.)</fundingNumber></fundingInfo><abstractGroup><abstract type="main" xml:lang="en"><title type="main">Abstract</title><p>Age and severity of extrapyramidal signs have been consistently associated with incident dementia in Parkinson's disease. We evaluated the separate and combined effects of age and severity of extrapyramidal signs on the risk of incident dementia in Parkinson's disease in the setting of a population‐based prospective cohort study. Age and the total Unified Parkinson's Disease Rating Scale motor score at baseline evaluation were dichotomized at the median. Four groups of Parkinson's disease patients were defined: younger age/low severity (reference), younger age/high severity, older age/low severity, and older age/high severity. Risk ratios for incident dementia were calculated with Cox proportional hazards models controlling for gender, education, ethnicity, and duration of Parkinson's disease. Of 180 patients, 52 (28.9%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. The median age at baseline of the Parkinson's disease patients was 71.8 years (range, 38.5–95.9 years), and the median total Unified Parkinson's Disease Rating Scale motor score was 24 (range, 2–65). The group with older age/high severity had a significantly increased risk of incident dementia (relative risk, 9.7; 95% confidence interval, 3.9–24.4) compared with the group with younger age/low severity (reference), whereas the groups with older age/low severity (relative risk, 1.6; 95% confidence interval, 0.5–4.8) and younger age/high severity (relative risk, 1.2; 95% confidence interval, 0.5–3.2) did not. These findings suggest that the increased risk of incident dementia in Parkinson's disease associated with age and severity of extrapyramidal signs is related primarily to their combined effect rather than separate effects.</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Combined effect of age and severity on the risk of dementia in Parkinson's disease</title></titleInfo><titleInfo type="abbreviated" lang="en"><title>Dementia in Parkinson's disease</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Combined effect of age and severity on the risk of dementia in Parkinson's disease</title></titleInfo><name type="personal"><namePart type="given">Gilberto</namePart><namePart type="family">Levy</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Gertrude H. Sergievsky Center and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Nicole</namePart><namePart type="family">Schupf</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Gertrude H. Sergievsky Center and</affiliation><affiliation>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY</affiliation><affiliation>New York State Institute for Basic Research in Developmental Disabilities, Staten Island, NY</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ming‐Xin</namePart><namePart type="family">Tang</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Gertrude H. Sergievsky Center and</affiliation><affiliation>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY</affiliation><affiliation>Division of Biostatistics, School of Public Health Departments of</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Lucien J.</namePart><namePart type="family">Cote</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>Neurology and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Elan D.</namePart><namePart type="family">Louis</namePart><namePart type="termsOfAddress">MD, MS</namePart><affiliation>Gertrude H. Sergievsky Center and</affiliation><affiliation>Neurology and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Helen</namePart><namePart type="family">Mejia</namePart><namePart type="termsOfAddress">MA</namePart><affiliation>Gertrude H. Sergievsky Center and</affiliation><affiliation>Neurology and</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Yaakov</namePart><namePart type="family">Stern</namePart><namePart type="termsOfAddress">PhD</namePart><affiliation>Gertrude H. Sergievsky Center and</affiliation><affiliation>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY</affiliation><affiliation>Neurology and</affiliation><affiliation>Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Karen</namePart><namePart type="family">Marder</namePart><namePart type="termsOfAddress">MD, MPH</namePart><affiliation>Gertrude H. Sergievsky Center and</affiliation><affiliation>Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY</affiliation><affiliation>Neurology and</affiliation><description>Correspondence: Gertrude H. Sergievsky Center, 630 West 168th Street, New York, NY 10032</description><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher><place><placeTerm type="text">New York</placeTerm></place><dateIssued encoding="w3cdtf">2002-06</dateIssued><dateCaptured encoding="w3cdtf">2001-11-26</dateCaptured><dateValid encoding="w3cdtf">2002-02-22</dateValid><copyrightDate encoding="w3cdtf">2002</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="figures">1</extent><extent unit="tables">5</extent><extent unit="references">57</extent><extent unit="words">6370</extent></physicalDescription><abstract lang="en">Age and severity of extrapyramidal signs have been consistently associated with incident dementia in Parkinson's disease. We evaluated the separate and combined effects of age and severity of extrapyramidal signs on the risk of incident dementia in Parkinson's disease in the setting of a population‐based prospective cohort study. Age and the total Unified Parkinson's Disease Rating Scale motor score at baseline evaluation were dichotomized at the median. Four groups of Parkinson's disease patients were defined: younger age/low severity (reference), younger age/high severity, older age/low severity, and older age/high severity. Risk ratios for incident dementia were calculated with Cox proportional hazards models controlling for gender, education, ethnicity, and duration of Parkinson's disease. Of 180 patients, 52 (28.9%) became demented during a mean follow‐up period of 3.6 ± 2.2 years. The median age at baseline of the Parkinson's disease patients was 71.8 years (range, 38.5–95.9 years), and the median total Unified Parkinson's Disease Rating Scale motor score was 24 (range, 2–65). The group with older age/high severity had a significantly increased risk of incident dementia (relative risk, 9.7; 95% confidence interval, 3.9–24.4) compared with the group with younger age/low severity (reference), whereas the groups with older age/low severity (relative risk, 1.6; 95% confidence interval, 0.5–4.8) and younger age/high severity (relative risk, 1.2; 95% confidence interval, 0.5–3.2) did not. These findings suggest that the increased risk of incident dementia in Parkinson's disease associated with age and severity of extrapyramidal signs is related primarily to their combined effect rather than separate effects.</abstract><note type="funding">federal grants - No. AG10963 (K.M., H.M.); No. AG07232 (K.M., Y.S.); No. RR00645 (K.M.); No. NS36630 (K.M., E.L., G.L.); </note><note type="funding">Parkinson's Disease Foundation - No. 611406 (K.M., Y.S., H.M.); </note><relatedItem type="host"><titleInfo><title>Annals of Neurology</title><subTitle>Official Journal of the American Neurological Association and the Child Neurology Society</subTitle></titleInfo><titleInfo type="abbreviated"><title>Ann Neurol.</title></titleInfo><genre type="Journal">journal</genre><subject><genre>article category</genre><topic>Original Articles</topic></subject><identifier type="ISSN">0364-5134</identifier><identifier type="eISSN">1531-8249</identifier><identifier type="DOI">10.1002/(ISSN)1531-8249</identifier><identifier type="PublisherID">ANA</identifier><part><date>2002</date><detail type="volume"><caption>vol.</caption><number>51</number></detail><detail type="issue"><caption>no.</caption><number>6</number></detail><extent unit="pages"><start>722</start><end>729</end><total>8</total></extent></part></relatedItem><identifier type="istex">B0F2FEFEFB359DABFA83451D564B46A62585A378</identifier><identifier type="DOI">10.1002/ana.10219</identifier><identifier type="ArticleID">ANA10219</identifier><accessCondition type="use and reproduction" contentType="copyright">Copyright © 2002 Wiley‐Liss, Inc.</accessCondition><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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