Harm avoidance is associated with progression of parkinsonism in community-dwelling older adults: a prospective cohort study

BMC Geriatrics

Research Article

Joshua M Shulman¹  Lei Yu²  Robert S Wilson³  Patricia A Boyle³  David A Bennett⁴  Aron S Buchman⁴ 

[1] Departments of Neurology and Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA;Jan and Dan Duncan Neurological Research Institute, Houston, TX, USA;Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;Department of Behavioral Science, Rush University Medical Center, Chicago, IL, USA;Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA;Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA;

关键词: Late-life motor impairment;    Aging;    Parkinsonism;    Harm avoidance;   

DOI  :  10.1186/1471-2318-14-54

 received in 2013-06-24, accepted in 2014-04-14,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundWe tested the hypothesis that harm avoidance, a trait associated with behavioral inhibition, is associated with the rate of change in parkinsonism in older adults.MethodsAt baseline harm avoidance was assessed with a standard self-report instrument in 969 older people without dementia participating in the Rush Memory and Aging Project, a longitudinal community-based cohort study. Parkinsonism was assessed annually with a modified version of the motor section of the Unified Parkinson’s Disease Rating Scale (mUPDRS).ResultsAverage follow-up was 5 years. A linear mixed-effects model controlling for age, sex and education showed that for an average participant (female, 80 years old at baseline, with 14 years of education and a harm avoidance score of 10), the overall severity of parkinsonism increased by about 0.05 unit/ year (Estimate, 0.054, S.E., 0.007, p <0.001) and that the level of harm avoidance was associated with the progression of parkinsonism (Estimate, 0.004, S.E., 0.001, p <0.001). Thus, for an average participant, every 6 point (~1 SD) increase in harm avoidance score at baseline, the rate of progression of parkinsonism increased about 50% compared to an individual with an average harm avoidance score. This amount of change in parkinsonism over the course of the study was associated with about a 5% increased risk of death. The association between harm avoidance and progression of parkinsonism persisted when controlling for cognitive function, depressive symptoms, loneliness, neuroticism, late-life cognitive, social and physical activities and chronic health conditions.ConclusionA higher level of the harm avoidance trait is associated with a more rapid progression of parkinsonism in older adults.

【 授权许可】

CC BY   
© Buchman et al.; licensee BioMed Central Ltd. 2014