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Mild extrapyramidal signs and functional impairment in ageing
Marcus Richards1, Jacques Touchon, Bernard Ledesert
1MRC National Survey of Health and Development, University College London, UK. m.richards@ucl.ac.uk
Background:
Little is known about the clinical significance of mild extrapyramidal signs (EPS) in elderly individuals. We investigated whether EPS are associated with functional impairment in older people with cognitive decline.
Methods:
A sub-group of 105 participants from the EUGERIA Study of Cognitive Ageing without Parkinson's disease or dementia, but with informant evidence of cognitive decline, were followed across three years and underwent neurological examination and assessment of mental health, cognition and functional capacity.
Results:
28.6% had at least one EPS (resting tremor, muscular rigidity or akinesia, of which rigidity was the most frequent). EPS presence was significantly associated with functional impairment after controlling for age and cognitive impairment (AAMI), although the association was reduced to borderline significance after further adjustment for depression and psychotropic medication use. There was evidence of colinearity between EPS and depression, possibly suggesting similar underlying mechanisms.
Conclusions:
There is an association between mild EPS and functional impairment in older persons with evidence of cognitive decline, but free of dementia or Parkinson's disease.