Extrapyramidal signs in cognitively intact elderly people
1Department of Psychiatry for the Elderly, University of Leicester, The Bennion Centre, Glenfield General Hospital, Groby Road, Leicester LE3 9DZ, UK.
Aim:
to investigate the prevalence of extrapyramidal signs in elderly people and their relationship to disease.
Setting And Subjects:
151 non-demented subjects age 65 and over living within a defined geographical area in Nottingham who were participating in the MRC multicentre Cognitive Function and Ageing Study.
Measurements:
subjects were assessed at home. Extrapyramidal signs were rated according to a standardized neurological examination using items from the Unified Parkinson's Disease Rating Scale.
Results:
bradykinetic and hypokinetic abnormalities are a frequent finding, especially in the oldest old. Over 50% of subjects aged 80 or over demonstrated at least one such sign. Only 10% of subjects had any recorded neurological disease.
Conclusions:
the frequency of recognized neurological and other disease is insufficient to account for the rate of subtle extrapyramidal abnormalities found. These findings may thus represent intrinsic age-related changes in neurological functioning, this being consistent with previously described pathological changes in the substantia nigra and striatum in normal ageing.
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