Association between mild parkinsonian signs and mild cognitive impairment in a community
1The Gertrude H. Sergievsky Center, Taub Institute for Research on Alzheimer's Disease, New York, NY, USA. EDL2@columbia.edu
Background:
Mild parkinsonian signs (MPS) are associated with prevalent and incident dementia but it is not known whether they are associated with mild cognitive impairment (MCI).
Objective:
To determine whether MPS and specific MPS (changes in axial function, rigidity, tremor) are associated with MCI in nondemented community-dwelling older people in northern Manhattan, NY.
Methods:
Participants underwent neurologic assessment, including a modified motor portion of the Unified Parkinson Disease Rating Scale. MCI was diagnosed in nondemented participants who had cognitive impairment based on neuropsychological testing and no functional impairment. Participants with MCI were classified as having MCI with memory impairment (MCI+M) vs MCI without memory impairment (MCI-M).
Results:
MCI was present in 608 (27.3%) of 2,230 participants, including 255 participants with MCI+M and 353 with MCI-M; 1,622 participants did not have MCI. MPS were present in 369 (16.5%) of 2,230 participants. In a univariate logistic regression model, odds of MCI+M (vs no MCI) were 51% higher in participants with MPS compared to those with no MPS (OR = 1.51, 95% CI = 1.09 to 2.09, p = 0.01). Multivariate models yielded similar results (OR = 1.45, 95% CI = 1.03 to 2.05, p = 0.03). Rigidity was present in a higher proportion of participants with MCI+M compared to participants without MCI.
Conclusions:
Mild parkinsonian signs, especially rigidity, are associated with amnestic mild cognitive impairment. Mild parkinsonian signs and mild cognitive impairment may share similar pathogeneses. Whether this involves Alzheimer-type pathology, Lewy bodies, or vascular changes in the basal ganglia or basal ganglia circuitry deserves further investigation in postmortem studies.
Insights
Mild parkinsonian signs (MPS) are linked to mild cognitive impairment (MCI) in older adults. Rigidity, a specific MPS, was notably associated with amnestic MCI, suggesting shared underlying causes.
Area of Science:
- Neurology
- Geriatrics
- Cognitive Science
Background:
- Mild parkinsonian signs (MPS) are known risk factors for dementia.
- The association between MPS and mild cognitive impairment (MCI) remains unclear.
Purpose of the Study:
- To investigate the relationship between MPS and MCI in nondemented older adults.
- To identify specific MPS associated with MCI, including axial function, rigidity, and tremor.
Main Methods:
- Neurologic assessments, including the Unified Parkinson Disease Rating Scale, were performed.
- Mild cognitive impairment (MCI) was diagnosed using neuropsychological testing in participants without cognitive or functional impairment.
- Participants with MCI were categorized into MCI with memory impairment (MCI+M) and MCI without memory impairment (MCI-M).
Main Results:
- Mild cognitive impairment (MCI) was diagnosed in 27.3% of participants.
- Mild parkinsonian signs (MPS) were present in 16.5% of participants.
- Participants with MPS had a 51% higher odds of MCI with memory impairment (MCI+M) compared to those without MPS (OR = 1.51). Rigidity was more prevalent in MCI+M.
Conclusions:
- Mild parkinsonian signs (MPS), particularly rigidity, are associated with amnestic mild cognitive impairment (MCI+M).
- Shared pathogeneses may underlie MPS and MCI.
- Further research is needed to explore the role of Alzheimer's pathology, Lewy bodies, or vascular changes.
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