The aim of this cross-sectional study was to compare the role of aging in measures reflecting diurnal activity and immobility in 60 parkinsonian patients with predominant features of hypokinesia and rigidity and 100 healthy subjects aged 50 to 98 years. In the patients, we also studied the relation between disease duration and subjective and objective measures of disease severity. Motor activity was recorded during 5 successive days at home with a wrist-worn activity monitor. For each subject, two mean measures reflecting the diurnal activity level and the relative proportion of activity and immobility were calculated. Diurnal measures of activity revealed in both groups a prominent absolute reduction of activity and an increase of the time spent without movement ("immobility") with advancing age. Parkinsonian patients showed significantly lower values for both motor-activity measures than did the healthy subjects. The rate of the age-related decline of both diurnal activity measures in both groups, however, is comparable. Disease duration showed no relation with subjective and objective measures reflecting disease severity. This study shows that if care is taken to control for disease severity, the rate of the age-related decline of measures reflecting diurnal activity and immobility is similar in both groups. The lack of relation between disease duration and subjective and objective measures of disease severity suggests that the rate of progression of Parkinson's disease can be reliably studied only by means of longitudinal studies.
Objective: To measure the influence of age on measures of nocturnal activity and immobility in 100 healthy subjects aged 50 to 98 years. Design: Cross-sectional study. Setting: Urban population in Leiden. Recordings were performed at home while the subjects maintained their habitual 24-hour pattern of activities. Participants: 100 subjects without a history of major medical disorders and a normal neurological examination and performance-oriented assessment of gait (Tinetti). Measurements: Motor activity was recorded during six successive nights with a wrist-worn activity monitor. The occurrence of supra-threshold motor activity was recorded over 15-second epochs. A questionnaire was used to evaluate sleep habits and the occurrence of sleep disturbances. Four mean From the departments of *Neurology and Clinical Neurophysiology of the Academic Hospital, and the departments of tMedical Statistics, $Physiology, and the section of §Gerontology
Secrecy and informal organisation produce, sustain, and reinforce feelings of loyalty within intelligence and security services. This article demonstrates that loyalty is needed for cooperation between intelligence partners as well as within and between services. Under many circumstances, loyalty plays a larger role in the level of internal and external collaboration than formal work processes along hierarchical lines. These findings are empirically based on the case study of Anglo‒Dutch intelligence cooperation during World War II. By demonstrating that ‘loyalty’ critically affects the work of intelligence communities, this article contributes to current and future research that integrates history, intelligence studies, and research on emotions.
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