Motor function and the probability of prodromal Parkinson's disease in older adults

Abstract

Background Identification and characterization of Parkinson's disease (PD) in its prodromal stage is crucial. Objective The objective of this study was to investigate the association between motor function and the probability of prodromal PD in a community‐dwelling older population. Methods We used data from a population‐based cohort of older adults (HELIAD study). Subjective motor function was evaluated with a 12‐item motor symptoms questionnaire and objective motor function indirectly with a physical activity questionnaire and two gait speed tests. The probability of prodromal PD was calculated according to the Movement Disorder Society research criteria for n = 1731 without PD. Regression multiadjusted models were used to investigate the associations between each motor measure and prodromal PD probability. Results For each unit increase in motor symptoms score and for each kcal/kg/day lower energy expenditure (corresponding to 20 minutes of light walking/day for a 75‐kg man) there was a 27% and 3% higher probability for prodromal PD, respectively (P < 0.001). Having at least one subjective motor symptom increased the odds of having possible/probable prodromal PD (n = 49; P < 0.05). Including subjective and indirect motor variables in the same model showed that both (symptoms and physical activity) contributed significantly to the model (P < 0.01). Excluding subthreshold parkinsonism from the calculation showed that gait speed less than 0.8 m/s was also associated with a higher prodromal PD probability score (P < 0.001). Conclusions Subjective motor symptoms as well as simple objective motor measures of physical activity or gait speed are associated with a higher probability of prodromal PD in older adults. These data may serve to enable the early identification of prodromal PD cohorts, particularly if they are confirmed in longitudinal studies. © 2019 International Parkinson and Movement Disorder Society

Correlates of polyneuropathy in Parkinson’s disease

“…The subjective perception of functional deficits plays an important role for both sensory and motor symptoms in all disease stages of PD 19 . We have quantified patient‐reported PNP symptoms with the NSS and correlated it to motor and nonmotor symptom scores.…”

A Prospective Validation of the Updated Movement Disorders Society Research Criteria for Prodromal Parkinson's Disease

“…Clinical evaluations, including neurological clinical examination, were made by certified neurologists or, in rare occasions, by senior residents in neurology. Trained neuropsychologists were responsible for the neuropsychological assessment 11‐13 . For each participant, demographic data (age, sex) were collected together with detailed information on their medical history and family history (first‐degree relatives) and use of medications and tobacco products.…”

“…Details on how we ascertained the risk and prodromal markers already included in the 2015 MDS pPD criteria can be found in previous publications on the HELIAD population 12,13,27 . Regarding the markers added in the 2019 MDS pPD criteria, several definitions were used.…”

“…The performance of the 2019 and 2015 MDS pPD criteria was assessed in the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) study 11 . HELIAD is a population‐based, multidisciplinary study designed to explore the associations between nutrition and cognitive impairment or other age‐related neuropsychiatric conditions 11‐13 . Participants came from a random sample of community‐dwelling individuals aged ≥65 years residing in 2 different areas of Greece.…”

Deep Phenotyping of Parkinson’s Disease

“…They have quantified the gait speed of individuals in their natural environment, and they and others have found that declines in walking speed predict cognitive impairment and dementia [66][67][68]. Similarly, reductions in daily physical activity are associated with an increased risk of Alzheimer's disease and potentially PD [69][70][71]. Multiple non-motor features, including autonomic function and sleep, can also be evaluated.…”