title: Mild parkinsonian signs in the elderly--is there an association with PD? Crossectional findings in 992 individuals.
abstract: BACKGROUND
  Mild parkinsonian signs (MPS) are common in the elderly population, and have been associated with vascular diseases, mild cognitive impairment and dementia; however their relation to Parkinson's disease (PD) is unclear. Hypothesizing that individuals with MPS may reflect a pre-stage of PD, i.e. a stage in which the nigrostriatal system is already affected although to a milder degree than at the time of PD diagnosis, aim of this study was to evaluate the similarities between MPS and PD.
  
  
  METHODS
  The TREND study is a prospective cross-sectional cohort study in individuals >50 years with biennial assessments designed to identify markers for an earlier diagnosis of Parkinson's and Alzheimer's disease. For this substudy 992 individuals were included for analyses (892 controls, 73 MPS individuals, 27 PD patients). Parameters defining risk of PD (sex, age, positive family history), prodromal markers (hyposmia, REM sleep behavior disorder, depression and autonomic failure) as well as quantitative fine motor, axial motor and cognitive parameters were compared between the three cohorts.
  
  
  RESULTS
  As expected, PD patients differed from controls with regard to 12 of 15 of the assessed parameters. MPS individuals differed significantly from controls in 12 of the PD-associated parameters, but differed from PD only in 5 parameters.
  
  
  CONCLUSIONS
  This study shows that individuals with MPS share many prodromal and clinical markers of PD with PD patients, implying that either a common dynamic process or similar constitutional factors occur in MPS individuals and PD patients.
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
authors.forename: Stefanie
authors.initials: S
authors.lastname: Lerche
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
authors.forename: Markus
authors.initials: M
authors.lastname: Hobert
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
authors.forename: Kathrin
authors.initials: K
authors.lastname: Brockmann
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
authors.forename: Isabel
authors.initials: I
authors.lastname: Wurster
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gaenslen
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
authors.forename: Sandra
authors.initials: S
authors.lastname: Hasmann
authors.affiliation: Geriatric Center and Department of Psychiatry and Psychotherapy, University Hospital of Tübingen, Tübingen, Germany.
authors.forename: Gerhard W
authors.initials: GW
authors.lastname: Eschweiler
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
authors.forename: Walter
authors.initials: W
authors.lastname: Maetzler
authors.affiliation: Center of Neurology, Department of Neurodegeneration and Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany; German Center for Neurodegenerative Diseases, University of Tübingen, Tübingen, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Berg
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010300:Parkinson Disease / Q000175:diagnosis* / Q000453:epidemiology*; D020734:Parkinsonian Disorders / Q000175:diagnosis*; D010808:Physical Examination; D012307:Risk Factors