title: Parkinsonian signs in older people: prevalence and associations with smoking and coffee.
abstract: BACKGROUND
  Cigarette smoking and coffee consumption may reduce the risk of PD. Parkinsonian signs (tremor, rigidity, bradykinesia) occur in 30 to 40% of the elderly.
  
  
  OBJECTIVE
  To determine whether there was an association between cigarette smoking, coffee consumption, and parkinsonian signs in a community population of older people.
  
  
  METHODS
  Data on smoking were collected and a neurologic examination performed on 1,339 residents > or = 65 years of age in the Washington Heights-Inwood community in northern Manhattan, NY. Parkinsonian signs were rated with an abbreviated Unified Parkinson's Disease Rating Scale, resulting in a parkinsonian sign score. Coffee consumption was assessed with a semiquantitative food-frequency questionnaire, and caffeine consumption was determined. Analyses were cross-sectional.
  
  
  RESULTS
  Mean age was 76.6 years. Parkinsonian signs were present in 537 (40.1%). The odds for presence of parkinsonian signs was lower in smokers than nonsmokers (odds ratio [OR] = 0.58, 95% CI = 0.47 to 0.73). Smokers had a lower mean parkinsonian sign score than nonsmokers (p < 0.001). Coffee drinking and caffeine consumption were not associated with the presence of parkinsonian signs. The odds for presence of parkinsonian signs remained lower in smokers (OR = 0.75, 95% CI = 0.57 to 0.99) after adjusting for age, gender, ethnicity, years of education, adjusted daily caffeine consumption, and dementia.
  
  
  CONCLUSIONS
  The reduced risk of parkinsonian signs in cigarette smokers could reflect a protective effect of smoking on age-related parkinsonian signs in the elderly or an aversion to smoking in elderly persons with mild parkinsonism.
authors.affiliation: Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA. EDL2@columbia.edu
authors.forename: Elan D
authors.initials: ED
authors.lastname: Louis
authors.forename: Jose A
authors.initials: JA
authors.lastname: Luchsinger
authors.forename: Ming X
authors.initials: MX
authors.lastname: Tang
authors.forename: Richard
authors.initials: R
authors.lastname: Mayeux
mesh_terms: D000368:Aged; D044383:Black People / Q000706:statistics & numerical data; D003069:Coffee; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data; D006801:Humans; D008297:Male; D009460:Neurologic Examination; D009483:Neuropsychological Tests; D009518:New York / Q000453:epidemiology; D016017:Odds Ratio; D020734:Parkinsonian Disorders / Q000175:diagnosis* / Q000453:epidemiology*; D015995:Prevalence; D018570:Risk Assessment; D012907:Smoking / Q000453:epidemiology*; D044465:White People / Q000706:statistics & numerical data; D001741:Black or African American
chemical_list: D003069:Coffee