Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Sweden.
Division of Geriatric Medicine, Department of Clinical Sciences in Malmö, Lund University, Skåne University Hospital, Sweden.
Parkinsonism Relat Disord. 2023 Jun;111:105416. doi: 10.1016/j.parkreldis.2023.105416. Epub 2023 Apr 25.
Mild parkinsonian signs (MPS) have been characterized by several definitions, using the motor part of the Unified Parkinson's Disease Rating Scale (UPDRS). We aimed to investigate the prevalence of MPS and their association with functional level and comorbidities in the oldest old.
Community-dwelling older adults (n = 559, median age 85, range 80-102 years) were examined regarding MPS, possible parkinsonism (PP) and subthreshold parkinsonism (SP) according to four previously used definitions and concerning the impact of parkinsonian signs on cognitive, physical, and autonomic function. MPS, PP and SP are different terms describing a very similar phenomenon and there is no gradation between these. In two of the four definitions more advanced symptoms were categorized as parkinsonism.
Median UPDRS score in the whole study group was 10 points (range: 0-58) and was predominated by bradykinesia. MPS/PP/SP were present in 17-85%, and parkinsonism in 33-71% of the cohort. Independently of age and gender, MPS/PP/SP and especially parkinsonism, were associated with a higher risk of fear of falling and accomplished falls, with lower: cognition, ADL, physical activity and quality of life, and with urinary incontinence, obstipation and orthostatic intolerance.
In a population of older adults above 80 years, MPS are highly prevalent as well as more advanced symptoms defined as parkinsonism, and only 9-17% of the cohort is symptom-free. Predominance of bradykinesia in the oldest old might indicate a need for revision of MPS definitions to improve their sensibility.
轻度帕金森症状（MPS）已通过几种定义进行了描述，这些定义使用了统一帕金森病评定量表（UPDRS）的运动部分。我们旨在研究最年长老年人中 MPS 的患病率及其与功能水平和合并症的关联。
对 559 名居住在社区的老年人（中位数年龄 85 岁，范围 80-102 岁）进行检查，根据之前使用的四个定义，检查 MPS、可能的帕金森病（PP）和亚阈值帕金森病（SP），并检查帕金森病症状对认知、身体和自主功能的影响。MPS、PP 和 SP 是描述非常相似现象的不同术语，它们之间没有等级之分。在四个定义中的两个中，更高级的症状被归类为帕金森病。
整个研究组的 UPDRS 评分中位数为 10 分（范围：0-58），以运动迟缓为主。MPS/PP/SP 存在于 17-85%的患者中，帕金森病存在于 33-71%的患者中。独立于年龄和性别，MPS/PP/SP 尤其是帕金森病，与跌倒恐惧和跌倒发生率增加、认知、ADL、身体活动和生活质量下降以及尿失禁、便秘和直立不耐受有关。
在 80 岁以上的老年人人群中，MPS 非常普遍，定义为帕金森病的更高级症状也很常见，而只有 9-17%的患者无症状。在最年长的老年人中运动迟缓占主导地位，可能表明需要修订 MPS 定义以提高其敏感性。
