title: Clinical characteristics related to worsening of motor function assessed by the Unified Parkinson's Disease Rating Scale in the elderly population.
abstract: There is evidence that nigrostriatal pathology may at least partly underlie mild Parkinsonian signs. We evaluated whether an increase in the Unified Parkinson's Disease Rating Scale part III (UPDRS-III) could be predicted by the presence of risk and prodromal markers for neurodegenerative diseases in elderly individuals without those diseases. Therefore, we analyzed the UPDRS-III score and various risk and prodromal markers known to antecede neurodegenerative diseases in a population-based cohort comprising 807 individuals free of neurodegenerative diseases at baseline. After 5 years, eight persons (1.0 %) were diagnosed with Parkinson's Disease (PD). Of those, seven (87.5 %) had motor worsening ≥3 points on the UPDRS-III from baseline to follow-up, one had two points increase. Of the 788 people without PD, 568 (72.1 %) showed no increase in the UPDRS-III scale, 220 (27.9 %) had ≥1 point increase and out of these 104 (13.2 %) had an increase of ≥3 points in the UPDRS-III score after 5 years. We identified an age >60 years (relative risk, RR = 1.7; confidence interval, CI 1.3-2.1) and the occurrence of ≥2 risk factors (RR = 1.5; CI 1.2-1.9) as possible predictors of motor progression. After 5 years, individuals with an increase in the UPDRS-III score had more often a one-sided reduced arm swing (p < 0.001) and identified less odors in the Sniffin' sticks test (p < 0.041) than persons with stable motor performance. Our data support the assumption that progression of Parkinsonian signs assessed by the UPDRS-III parallels the development of prodromal markers for neurodegenerative diseases in the elderly population.
authors.affiliation: Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany, inga.liepelt@dzne.de.
authors.forename: Inga
authors.initials: I
authors.lastname: Liepelt-Scarfone
authors.forename: Stefanie
authors.initials: S
authors.lastname: Lerche
authors.forename: Stefanie
authors.initials: S
authors.lastname: Behnke
authors.forename: Jana
authors.initials: J
authors.lastname: Godau
authors.forename: Alexandra
authors.initials: A
authors.lastname: Gaenslen
authors.forename: Christoph
authors.initials: C
authors.lastname: Pausch
authors.forename: Klaus
authors.initials: K
authors.lastname: Fassbender
authors.forename: Kathrin
authors.initials: K
authors.lastname: Brockmann
authors.forename: Karin
authors.initials: K
authors.lastname: Srulijes
authors.forename: Heiko
authors.initials: H
authors.lastname: Huber
authors.forename: Isabel
authors.initials: I
authors.lastname: Wurster
authors.forename: Daniela
authors.initials: D
authors.lastname: Berg
mesh_terms: D000368:Aged; D018450:Disease Progression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009043:Motor Activity / Q000502:physiology*; D010300:Parkinson Disease / Q000503:physiopathology*; D062706:Prodromal Symptoms; D012307:Risk Factors; D012720:Severity of Illness Index