title: The association between non-motor symptoms in Parkinson's disease and age at onset.
abstract: OBJECTIVE
  Age at onset is likely to be related to a wide range of problems in Parkinson's disease (PD), including cardinal motor features, motor complications and non-motor symptoms (NMS). This study investigated the effect of the age at onset on NMS.
  
  
  METHODS
  Two hundred and thirty patients were examined and classified into one of three groups based on age at onset: early onset PD (EOPD) group (<45 years), middle-age onset group (45-64 years) and old-age onset group (≥65 years). The trends relating to NMS were compared across the three groups. The EOPD and old-age onset groups were separately studied to determine their association to the appearance of non-motor features using logistic regression analysis.
  
  
  RESULTS
  There were upward trends in the occurrence of dribbling (P=0.009; all P values are stated for trend), impaired taste/smelling (P=0.016), constipation (P=0.006), urinary urgency (P=0.002), nocturia (P=0.018), hallucinations (P=0.016) and acting out during dreams (P=0.011) with the increase of age at onset. Older age at onset is an independent risk factor for dementia (OR=8.42, CI 3.16-22.44), dribbling (OR=4.14, CI 1.93-8.87), impaired taste/smelling (OR=2.23, CI 1.20-4.13), constipation (OR=3.42, CI 1.88-6.24), incomplete bowel emptying (OR=2.23, CI 1.19-4.20), urinary urgency (OR=2.58 CI 1.46-4.57), nocturia (OR=2.65, CI 1.49-4.71), hallucinations (OR=5.32, CI 1.78-15.97), dizziness (OR=3.03, CI 1.59-5.79), falling (OR=3.60, CI 1.67-7.77), insomnia (OR=2.29, CI 1.28-4.11), intense vivid dreaming (OR=2.10, CI 1.21-3.66) and acting out during dreams (OR=2.23, CI 1.24-4.01).
  
  
  CONCLUSIONS
  PD patients with different ages at onset present clinically different symptoms in terms of NMS. Old-age onset PD is characterized by more olfactory and sensory symptoms, autonomic symptoms, sleep disorders, dementia and psychosis compared to EOPD.
authors: Department of Neurology, Xinhua Hospital, Shanghai Jiaotong, University, School of Medicine, Shanghai, China.
authors: Ming-Zhu
authors: MZ
authors: Zhou
authors: Jin
authors: J
authors: Gan
authors: Ya-Rong
authors: YR
authors: Wei
authors: Xiao-Yu
authors: XY
authors: Ren
authors: Wei
authors: W
authors: Chen
authors: Zhen-Guo
authors: ZG
authors: Liu
mesh_terms: D000203:Activities of Daily Living; D017668:Age of Onset; D000368:Aged; D001007:Anxiety / Q000453:epidemiology / Q000209:etiology; D001342:Autonomic Nervous System Diseases / Q000453:epidemiology / Q000209:etiology; D003863:Depression / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000453:epidemiology / Q000209:etiology; D008875:Middle Aged; D010300:Parkinson Disease / Q000453:epidemiology / Q000503:physiopathology*; D015995:Prevalence; D011569:Psychiatric Status Rating Scales; D012893:Sleep Wake Disorders / Q000453:epidemiology / Q000209:etiology; D011795:Surveys and Questionnaires
keywords: Age at onset; Axial impairment; Non-motor symptoms; Parkinson's disease