Parkinsonianlike signs and risk of incident Alzheimer disease in older persons
Parkinsonianlike signs and risk of incident Alzheimer disease in older persons
复制标题
DOI：
10.1001/archneur.60.4.539
复制
发表时间：
2003-04-01
影响因子：
--
通讯作者：
Bennett, DA
中科院分区：
文献类型：
--
作者：
Wilson, RS;Schneider, JA;Bennett, DA
背景资料：帕金森样体征在老年人中很常见，但其严重程度或进展速度与阿尔茨海默病（AD）或认知功能下降的关系尚不清楚。目的：研究帕金森样体征进展与AD和认知功能下降的关系。设计：纵向队列研究。参与者和设置：在长达8年的时间里，824名在基线时没有AD或帕金森病临床证据的老年天主教神职人员接受了年度临床评估，其中包括修改后的统一帕金森病评定量表（UMRS），详细的认知功能测试，AD的临床分类。主要结果测量：临床诊断的AD和认知功能的整体和特定测量的变化。结果：在平均4.6年的观察期间，114人发展为AD。79%的参与者的总体UPDRS评分增加，他们被分为进展最慢、中等或最快的三分之一。我们在一个比例风险模型中检查了疾病进展与疾病风险的关系，该模型控制了基线全球疾病风险和人口统计学变量。与21%未进展的患者相比，进展最少的亚组中AD的风险增加了一倍以上（P= 0.08），中度亚组中增加了两倍以上（P= 0.02），进展最快的亚组中增加了8倍以上（P
Background: Parkinsonianlike signs are common in older persons, but little is known about how their severity or rate of progression is related to the development of Alzheimer disease (AD) or decline in cognition.Objective: To examine the association of progression of parkinsonianlike signs with incident AD and cognitive decline.Design: Longitudinal cohort study.Participants and Setting: For up to 8 years, 824 older Catholic clergy members without clinical evidence of AD or Parkinson disease at baseline underwent annual clinical evaluations that included a modified version of the Unified Parkinson's Disease Rating Scale (UPDRS), detailed cognitive function testing,,and clinical classification of AD.Main Outcome Measures: Clinically diagnosed AD and change in global and specific measures of cognitive function.Results: During an average of 4.6 years of observation, 114 persons developed AD. The global UPDRS score increased in 79% of participants, who were divided into tertiles with the least, moderate, or most rapid progression. We examined the relationship of progression to disease risk in a proportional hazards model that controlled for baseline global UPDRS and demographic variables. Compared with the 21% without progression, risk of AD more than doubled in the subgroup with the least progression (P=.08), more than tripled in the moderate subgroup (P=.02), and increased more than 8-fold in the subgroup with the most rapid progression (P