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Clinical characteristics related to worsening of motor function assessed by the Unified Parkinson’s Disease Rating Scale in the elderly population

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Abstract

There is evidence that nigrostriatal pathology may at least partly underlie mild Parkinsonian signs. We evaluated whether an increase in the Unified Parkinson’s Disease Rating Scale part III (UPDRS-III) could be predicted by the presence of risk and prodromal markers for neurodegenerative diseases in elderly individuals without those diseases. Therefore, we analyzed the UPDRS-III score and various risk and prodromal markers known to antecede neurodegenerative diseases in a population-based cohort comprising 807 individuals free of neurodegenerative diseases at baseline. After 5 years, eight persons (1.0 %) were diagnosed with Parkinson’s Disease (PD). Of those, seven (87.5 %) had motor worsening ≥3 points on the UPDRS-III from baseline to follow-up, one had two points increase. Of the 788 people without PD, 568 (72.1 %) showed no increase in the UPDRS-III scale, 220 (27.9 %) had ≥1 point increase and out of these 104 (13.2 %) had an increase of ≥3 points in the UPDRS-III score after 5 years. We identified an age >60 years (relative risk, RR = 1.7; confidence interval, CI 1.3–2.1) and the occurrence of ≥2 risk factors (RR = 1.5; CI 1.2-1.9) as possible predictors of motor progression. After 5 years, individuals with an increase in the UPDRS-III score had more often a one-sided reduced arm swing (p < 0.001) and identified less odors in the Sniffin’ sticks test (p < 0.041) than persons with stable motor performance. Our data support the assumption that progression of Parkinsonian signs assessed by the UPDRS-III parallels the development of prodromal markers for neurodegenerative diseases in the elderly population.

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Acknowledgments

We thank the PRIPS study group who helped at different points in time of this longitudinal study: Dr. Katherine Schweitzer, Dr. Björn Wolf, Dr. Theresa Schubert, Dr. Marianne Bentele, Anne Runkel, Dr. Frank Wollenweber, Dr. Jörg Spiegel, Teresa Hiry, Mareike Probst, Vera Schneider, Niko Schneider, Martin Sawires, and Dr. Walter Maetzler. Moreover, we are thankful to the Bosch GmbH and the Walter AG who helped in recruitment and retention of participants. We very much appreciate the commitment of all who volunteered to participate in this study for 5 years. The Michael J Fox Foundation supported the assessments of the first and second follow-up financially.

Conflicts of interest

On behalf of all the authors, the corresponding author states that there is no conflict of interest.

Ethical standard

The study was approved by the local ethical committees and all participants gave written informed consent.

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Authors and Affiliations

  1. Department of Neurodegeneration, Hertie Institute for Clinical Brain Research, Hoppe-Seyler Str. 3, 72076, Tübingen, Germany

    Inga Liepelt-Scarfone, Stefanie Lerche, Jana Godau, Alexandra Gaenslen, Kathrin Brockmann, Karin Srulijes, Heiko Huber, Isabel Wurster & Daniela Berg

  2. German Center of Neurodegenerative Diseases (DZNE), Tübingen, Germany

    Inga Liepelt-Scarfone, Stefanie Lerche, Jana Godau, Alexandra Gaenslen, Kathrin Brockmann, Karin Srulijes, Heiko Huber, Isabel Wurster & Daniela Berg

  3. Department of Neurology, University of Homburg/Saar, Homburg, Germany

    Stefanie Behnke, Christoph Pausch & Klaus Fassbender

Authors
  1. Inga Liepelt-Scarfone
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  2. Stefanie Lerche
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  7. Klaus Fassbender
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  8. Kathrin Brockmann
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  9. Karin Srulijes
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  10. Heiko Huber
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  11. Isabel Wurster
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Corresponding author

Correspondence to Inga Liepelt-Scarfone.

Additional information

I. Liepelt-Scarfone and S. Lerche contributed equally.

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Liepelt-Scarfone, I., Lerche, S., Behnke, S. et al. Clinical characteristics related to worsening of motor function assessed by the Unified Parkinson’s Disease Rating Scale in the elderly population. J Neurol 262, 451–458 (2015). https://doi.org/10.1007/s00415-014-7584-4

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  • DOI: https://doi.org/10.1007/s00415-014-7584-4

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