Predictors for mild parkinsonian signs: a prospective population-based study

Area of Science:

• Neurology
• Geriatrics
• Neuroimaging

Background:

• Mild parkinsonian signs (MPS) are prevalent in the elderly and linked to adverse health outcomes, including incident Parkinson's disease (PD).
• Identifying early risk factors for MPS is crucial for proactive healthcare interventions in aging populations.

Purpose of the Study:

• To prospectively investigate potential risk factors for the development of incident mild parkinsonian signs (MPS) in an elderly cohort.
• To evaluate the association of substantia nigra (SN)-echogenicity, olfactory function, and vascular risk with incident MPS.

Main Methods:

• Utilized data from the population-based Bruneck Study, assessing SN-echogenicity via transcranial sonography and olfactory function using the Sniffin' Sticks test.
• Excluded participants with baseline PD or MPS; analyzed 393 individuals using logistic regression adjusted for age and sex.
• Assessed MPS using established criteria from the Unified Parkinson's Disease Rating Scale motor examination at baseline and 5-year follow-up.

Main Results:

• SN-hyperechogenicity (OR 2.0) and hyposmia (OR 1.6) were significantly associated with incident MPS.
• Combined SN-hyperechogenicity and hyposmia showed a higher risk (OR 3.0) for developing MPS.
• SN-hyperechogenicity predicted bradykinesia and rigidity, while hyposmia predicted impaired axial motor function.

Conclusions:

• SN-hyperechogenicity and hyposmia are significant risk factors for incident MPS in the general elderly population.
• These findings reinforce the role of SN-echogenicity and olfactory dysfunction as early indicators, extending beyond their known association with Parkinson's disease.