Parkinsonian signs are associated with subtle functional deterioration in community-dwelling Chinese older persons

Abstract

Objective: To report the prevalence of mild parkinsonian signs and their association with functional impairment in a population-based study of clinically non-demented Chinese persons. Participants and Methods: A random sample of 765 Chinese older persons from a thematic household survey was recruited. There were 389 normal elderly controls (Clinical Dementia Rating = 0), 291 with mild cognitive impairment, and 85 with very mild dementia. The prevalence of mild parkinsonian signs and its association with everyday functional performance were investigated. Results: Mild parkinsonian signs were defined as a score of 2 or more in the Unified Parkinson's Disease Rating Scale-motor section. The prevalence of mild parkinsonian signs was 16.5%, 33.0% and 49.4% in the normal controls, those with mild cognitive impairment and very mild dementia, respectively. In each group, subjects with mild parkinsonian signs had lower functional scores than those without such signs, even after adjusting for the effect of age, sex, and education. Abnormality in axial function, bradykinesia, and rigidity were associated with lower scores for Instrumental Activities of Daily Living, and rigidity was associated with lower Basic Activities of Daily Living scores. Conclusion: The prevalence of mild parkinsonian signs increased with the severity of cognitive impairment in clinically non-demented older persons. Such signs were associated with functional impairment in older persons with mild cognitive impairment and very mild dementia. © 2008 Hong Kong College of Psychiatrists.