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© 1998 Oxford University Press

other

Extrapyramidal signs in cognitively intact elderly people

RICHARD PRETTYMAN

Department of Psychiatry for the Elderly, University of Leicester, The Bennion Centre, Glenfield General Hospital Groby Road, Leicester LE3 9DZ, UK. Fax: (+44) 116 2502770

Aim: to investigate the prevalence of extrapyramidal signs in elderly people and their relationship to disease. Setting and subjects: 151 non-demented subjects age 65 and over living within a defined geographical area in Nottingham who were participating in the MRC multicentre Cognitive Function and Ageing Study. Measurements: subjects were assessed at home. Extrapyramidal signs were rated according to a standardized neurological examination using items from the Unified Parkinson's Disease Rating Scale.

Results: bradykinetic and hypokinetic abnormalities are a frequent finding, especially in the oldest old. Over 50% of subjects aged 80 or over demonstrated at least one such sign. Only 10% of subjects had any recorded neurological disease.

Conclusions: the frequency of recognized neurological and other disease is insufficient to account for the rate of subtle extrapyramidal abnormalities found. These findings may thus represent intrinsic age-related changes in neurological functioning, this being consistent with previously described pathological changes in the substantia nigra and striatum in normal ageing.

Keywords: ageing, neurological defiat, parkinsonism

Received June 18, 1997; accepted in revised form October 31, 1997.


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