BACKGROUND: Motor signs (MOSIs) are common in Alzheimer disease (AD) and may be associated with rates of cognitive decline, mortality, and cost of care. OBJECTIVE: To describe the progression and identify predictors of individual MOSIs in AD. METHODS: A cohort of 474 patients with AD at early stages was followed semiannually for up to 13.1 years (mean 3.6 years) in five centers in Europe and the United States. MOSIs were rated using a standardized portion of the Unified Parkinson's Disease Rating Scale. Overall, 3,030 visits/assessments of MOSIs (average 6.4/patient) were performed. Prevalence and incidence rates were calculated, and cumulative risk graphs were plotted for individual non-drug-induced MOSI domains. Rates of change over time taking into account potential covariates were also estimated. With use of each MOSI domain as outcome in Cox models, predictors of MOSI incidence were identified. RESULTS: At least one MOSI was detected in 13% of patients at first examination and in 36% for the last evaluation. Total MOSI score increased at an annual rate of 3% of total possible score. Rates of annual change for speech/facial expression (4%), rigidity (2.45%), posture/gait (3.9%), and bradykinesia (3.75%) were of similar magnitude, and their occurrence increased from first (3 to 6%) to last (22 to 29%) evaluation. Tremor was less frequent throughout the course of the disease (4% at first and 7% at last evaluation) and worsened less (0.75% increase/year). CONCLUSIONS: Most motor signs occur frequently and progress rapidly in Alzheimer disease. Tremor is an exception in that it occurs less frequently and advances at slower rates.
BACKGROUND: Motor signs (MOSIs) are common in Alzheimer disease (AD) and may be associated with rates of cognitive decline, mortality, and cost of care. OBJECTIVE: To describe the progression and identify predictors of individual MOSIs in AD. METHODS: A cohort of 474 patients with AD at early stages was followed semiannually for up to 13.1 years (mean 3.6 years) in five centers in Europe and the United States. MOSIs were rated using a standardized portion of the Unified Parkinson's Disease Rating Scale. Overall, 3,030 visits/assessments of MOSIs (average 6.4/patient) were performed. Prevalence and incidence rates were calculated, and cumulative risk graphs were plotted for individual non-drug-induced MOSI domains. Rates of change over time taking into account potential covariates were also estimated. With use of each MOSI domain as outcome in Cox models, predictors of MOSI incidence were identified. RESULTS: At least one MOSI was detected in 13% of patients at first examination and in 36% for the last evaluation. Total MOSI score increased at an annual rate of 3% of total possible score. Rates of annual change for speech/facial expression (4%), rigidity (2.45%), posture/gait (3.9%), and bradykinesia (3.75%) were of similar magnitude, and their occurrence increased from first (3 to 6%) to last (22 to 29%) evaluation. Tremor was less frequent throughout the course of the disease (4% at first and 7% at last evaluation) and worsened less (0.75% increase/year). CONCLUSIONS: Most motor signs occur frequently and progress rapidly in Alzheimer disease. Tremor is an exception in that it occurs less frequently and advances at slower rates.
Authors: Y Stern; D Jacobs; J Goldman; E Gomez-Tortosa; B T Hyman; Y Liu; J Troncoso; K Marder; M X Tang; J Brandt; M Albert Journal: Arch Neurol Date: 2001-03
Authors: A Heyman; G G Fillenbaum; M Gearing; S S Mirra; K A Welsh-Bohmer; B Peterson; C Pieper Journal: Neurology Date: 1999-06-10 Impact factor: 9.910
Authors: N Scarmeas; J Brandt; M Albert; D P Devanand; K Marder; K Bell; A Ciappa; B Tycko; Y Stern Journal: Neurology Date: 2002-04-23 Impact factor: 9.910
Authors: Christian Wider; Owen A Ross; Kenya Nishioka; Michael G Heckman; Carles Vilariño-Güell; Barbara Jasinska-Myga; Nilufer Erketin-Taner; Rosa Rademakers; Neill R Graff-Radford; Deborah C Mash; Spiridon Papapetropoulos; Ranjan Duara; Hirotake Uchikado; Zbigniew K Wszolek; Matthew J Farrer; Dennis W Dickson Journal: J Neurol Neurosurg Psychiatry Date: 2012-01-30 Impact factor: 10.154
Authors: M E Soto; S Andrieu; C Arbus; M Ceccaldi; P Couratier; T Dantoine; J-F Dartigues; S Gillette-Guyonnet; F Nourhashemi; P-J Ousset; M Poncet; F Portet; J Touchon; B Vellas Journal: J Nutr Health Aging Date: 2008-12 Impact factor: 4.075
Authors: Nikolaos Scarmeas; Lawrence S Honig; Hyunmi Choi; Julio Cantero; Jason Brandt; Deborah Blacker; Marilyn Albert; Joan C Amatniek; Karen Marder; Karen Bell; W Allen Hauser; Yaakov Stern Journal: Arch Neurol Date: 2009-08