Liampas Ioannis, Demiri Silvia, Stamati Polyxeni, Lazarou Lefteris, Michailides Christos, Marogianni Chrysoula, Tsika Antonia, Siokas Vasileios, Dardiotis Efthimios
Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Medicine, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece.
School of Medicine, University of Patras, 26504, Patras, Greece.
Eur Geriatr Med. 2025 Jul 21. doi: 10.1007/s41999-025-01259-z.
Motor signs are frequently observed over the clinical course of Alzheimer's disease (AD). We explored the potential clinical associations of motor manifestations in AD.
Our sample consisted of older adults (≥ 60 years) with AD from NACC. Individuals with Parkinson's disease or other Parkinsonian syndrome or under anti-parkinsonian agents were excluded. UPDRS III was used to assess motor signs in nine domains: hypophonia; masked facies; resting tremor; action/postural tremor; rigidity; bradykinesia; impaired chair rise; impaired posture/gait; postural instability. A global motor variable assessed the presence of at least one motor sign. Binary logistic models were estimated for the global (primary) and individual motor domain variables (secondary outcomes).
A total of 4771 older, predominantly female, well-educated participants were analysed: 3556 without (75.4 ± 7.6 years, 45.6% males) and 1215 with motor manifestations (79.4 ± 7.8 years, 44.4% males). The most influential risk factor for motor manifestations in AD was the Clinical Dementia Rating stage: stage one increased the odds of motor signs by ~ 44%, stage two by ~ 168% and stage three by ~ 437%. Each additional point on the Geriatric Depression Scale elevated the odds of motor manifestations by ~ 5%, whereas each additional point on the Mini-Mental State Examination decreased these odds by ~ 2.5%. Cerebrovascular disease (by ~ 44%), diabetes mellitus (by ~ 25%), traumatic brain injury (by ~ 30%), alcohol abuse (by ~ 33%), anxiolytics (by ~ 36%), antidepressants (by ~ 31%), antipsychotics (by ~ 48%) and β-blockers (by ~ 33%) elevated the odds of motor manifestations. Angiotensin II receptor blockers decreased the odds of motor manifestations (by ~ 33%).
Disease progression constitutes the most crucial clinical risk factor for motor manifestations in AD.
在阿尔茨海默病（AD）的临床病程中经常观察到运动体征。我们探讨了AD中运动表现的潜在临床关联。
我们的样本包括来自NACC的≥60岁的AD老年患者。排除患有帕金森病或其他帕金森综合征或正在使用抗帕金森药物的个体。采用统一帕金森病评定量表第三部分（UPDRS III）在九个领域评估运动体征：声音低微；面具脸；静止性震颤；动作性/姿势性震颤；肌强直；运动迟缓；从椅子上起身困难；姿势/步态障碍；姿势不稳。一个总体运动变量评估至少一种运动体征的存在情况。对总体（主要）和个体运动领域变量（次要结果）估计二元逻辑模型。
共分析了4771名年龄较大、以女性为主、受过良好教育的参与者：3556名无运动表现者（75.4±7.6岁，45.6%为男性）和1215名有运动表现者（79.4±7.8岁，44.4%为男性）。AD中运动表现最具影响力的危险因素是临床痴呆评定阶段：第一阶段运动体征出现几率增加约44%，第二阶段增加约168%，第三阶段增加约437%。老年抑郁量表每增加一分，运动表现出现几率升高约5%，而简易精神状态检查表每增加一分，这些几率降低约2.5%。脑血管疾病（约44%）\u3001糖尿病（约25%）\u3001创伤性脑损伤（约30%）\u3001酒精滥用（约33%）\u三百\u3001抗焦虑药（约36%）\u3001抗抑郁药（约31%）\u3001抗精神病药（约48%）和β受体阻滞剂（约33%）使运动表现出现几率升高。血管紧张素II受体阻滞剂降低运动表现出现几率（约33%）。
疾病进展是AD中运动表现最关键的临床危险因素。
