Louis Elan D, Marder Karen, Tabert Matthias H, Devanand Devangere P
The Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Mov Disord. 2008 Mar 15;23(4):524-30. doi: 10.1002/mds.21777.
Mild Parkinsonian signs (MPS, impaired gait, rigidity, bradykinesia, rest tremor) are commonly found during the clinical examination of older people and may be a precursor to Parkinson's disease (PD) or Alzheimer's disease (AD). Marked deficits in olfaction occur in PD and AD. The objective of this study was to determine whether University of Pennsylvania Smell Test (UPSIT) scores were lower in nondemented community-dwelling elderly with versus without MPS. Nondemented persons age >or=65 years without PD in Washington Heights-Inwood, NY were evaluated with an abbreviated motor Unified PD Rating Scale and a 40-item UPSIT. Lower UPSIT and higher transformed UPSIT score (square root [UPSIT - 41]) indicated greater olfactory dysfunction. One-hundred-seventy-seven (16.4%) of 1,078 participants had MPS. Mean UPSIT scores (MPS vs. without MPS) were 24.3 +/- 7.1 versus 26.4 +/- 6.8, P < 0.001. In a logistic regression analysis adjusting for age and education, transformed UPSIT score was associated with MPS (OR 1.25, 95% CI 1.04-1.52, P = 0.02). In an adjusted logistic regression analysis, participants with higher transformed UPSIT scores (based on a median split) were 1.55 times more likely to have MPS than were those with lower scores (P = 0.01). Within transformed UPSIT score quartiles, the odds of having MPS were 1.0 (reference), 1.35, 2.02, and 2.20 (P < 0.05). The association with transformed UPSIT scores was similar across MPS subtypes (axial dysfunction, rigidity, tremor).MPS were associated with a mild reduction in olfactory function. These observations further support the view of MPS as a marker of emerging degenerative brain pathologies.
轻度帕金森氏征（MPS，步态障碍、僵硬、运动迟缓、静止性震颤）在老年人临床检查中很常见，可能是帕金森病（PD）或阿尔茨海默病（AD）的先兆。嗅觉明显减退在PD和AD中都有出现。本研究的目的是确定在无痴呆的社区居住老年人中，有MPS与无MPS者的宾夕法尼亚大学嗅觉测试（UPSIT）分数是否更低。对纽约华盛顿高地-因伍德年龄≥65岁且无PD的无痴呆者，使用简化运动统一PD评定量表和40项UPSIT进行评估。较低的UPSIT分数和较高的UPSIT转换分数（平方根[UPSIT - 41]）表明嗅觉功能障碍更严重。1078名参与者中有177名（16.4%）有MPS。平均UPSIT分数（有MPS与无MPS者）分别为24.3±7.1和26.4±6.8，P<0.001。在对年龄和教育程度进行校正的逻辑回归分析中，UPSIT转换分数与MPS相关（比值比1.25，95%可信区间1.04 - 1.52，P = 0.02）。在经校正的逻辑回归分析中，UPSIT转换分数较高（基于中位数分割）的参与者出现MPS的可能性是分数较低者的1.55倍（P = 0.01）。在UPSIT转换分数四分位数范围内，出现MPS的几率分别为1.0（参照）、1.35、2.02和2.20（P<0.05）。MPS各亚型（轴向功能障碍、僵硬、震颤）与UPSIT转换分数的关联相似。MPS与嗅觉功能轻度减退相关。这些观察结果进一步支持将MPS视为新兴退行性脑病变标志物的观点。
