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Rapid Progress in Alzheimers to Parkinsonian Signs
A DGReview of :"Progression of parkinsonian signs in Alzheimer's disease"
Neurology
04/20/2000
By David Ball
People with Alzheimer's disease (AD) may commonly show signs of Parkinson's disease without tremor.
While progression to Parkinsonian signs can be rapid, they occur at widely differing rates in individuals with AD, according to American researchers.
Over 90 per cent of a cohort of 410 AD patients completed a four-year follow-up study. Annual clinical evaluations were made using the entire motor portion of the Unified Parkinson's Disease Rating Scale (UPDRS). Previously established measures of four Parkinsonian signs were derived from the UPDRS and individual paths of change were estimated by a growth curve approach.
Substantial rates of change were found in bradykinesia (4.5 per cent increase per year), rigidity (6.0 per cent annual increase) and gait disorder/postural reflex impairment (8.9 per cent). There was minimal change in tremor which was confined mostly to postural tremor and correlated weakly with changes in other signs.
Individuals showed a highly variable rate of progression in each sign. These were not strongly related to the use of neuroleptic or demographic factors.
The researchers concluded that "Parkinsonian signs other than tremor progress rapidly in AD but at widely differing rates".
"Progression of parkinsonian signs in Alzheimer's disease"
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