Functional correlates of mild parkinsonian signs in the community-dwelling elderly: Poor balance and inability to ambulate independently
Functional correlates of mild parkinsonian signs in the community-dwelling elderly: Poor balance and inability to ambulate independently
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DOI：
10.1002/mds.20735
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发表时间：
2006-03-01
影响因子：
8.6
通讯作者：
Tang, MX
中科院分区：
文献类型：
--
作者：
Louis, ED;Schupf, N;Tang, MX
在没有已知神经系统疾病的老年人的临床检查中，经常发现轻度震颤、强直和运动迟缓（轻度帕金森症状，MPS）。这些偶然发现的功能相关性尚不清楚。平衡和独立行走能力是老年人的重要功能。本研究的目的是检查MPS是否与平衡受损有关。使用主观测量（抱怨平衡感差）和功能测量（需要使用助行器、手杖或轮椅）来评估平衡。我们的方法包括对纽约华盛顿高地因伍德的非痴呆老年人进行神经学评估。在2251名参与者中，527人（23.4%）抱怨平衡感差；538人（23.9%）需要使用手杖、助行器或轮椅；363例（16.1%）有MPS。在调整后的logistic回归分析中，MPS与抱怨平衡性差（OR = 1.5, 95% CI = 1.1-2.0）和需要使用手杖、助行器或轮椅（OR = 1.9, 95% CI = 1.4-2.6）相关。需要使用手杖、助行器或轮椅与轴向功能（or = 5.5, 95% CI = 2.6-11.6）和刚性（or = 1.5, 95% CI = 1.07-2.2）的变化有关。虽然它们是偶然和微妙的，但运动迟缓、强直和震颤的迹象与功能受损有关。与没有这些症状的老年人相比，有这些症状的老年人抱怨平衡性差的可能性要高50%，需要拐杖、助行器或轮椅的可能性要高90%。(c) 2005年运动障碍协会。
Mild tremor, rigidity, and bradykinesia (mild parkinsonian signs, MPS) are commonly detected during the clinical examination of elderly people without known neurological disease. The functional correlates of these incidental findings are not well understood. Balance and ability to ambulate independently are important functions in the elderly. The objective of this study is to examine whether MPS were associated with impaired balance. Balance was assessed using a subjective measure (complaint of poor balance) and a functional measure (the need to use a walker, cane, or wheelchair). Our methods included the neurological evaluation of nondemented older people in Washington Heights-Inwood, NY. Of 2,251 participants, 527 (23.4%) complained of poor balance; 538 (23.9%) required a cane, walker, or wheelchair; and 363 (16.1%) had MPS. In adjusted logistic regression analyses, MPS were associated with a complaint of poor balance (OR = 1.5, 95% CI = 1.1-2.0) and the need to use a cane, walker, or wheelchair (OR = 1.9, 95% CI = 1.4-2.6). The need to use a cane, walker, or wheelchair was associated with changes in axial function (OR = 5.5, 95% CI = 2.6-11.6) as well as rigidity (OR = 1.5, 95% CI = 1.07-2.2). Although they are incidental and subtle, signs of bradykinesia, rigidity, and tremor are associated with impaired function. The elderly in whom these signs have been detected are 50% more likely to complain of poor balance and 90% more likely to require a cane, walker, or wheelchair than are their counterparts without these signs. (c) 2005 Movement Disorder Society.