The motor phenotype of Parkinson's disease in relation to age at onset

Background: Parkinson's disease (PD) is heterogeneous and age at onset may define variation in clinical phenotype. Most previous studies have used various age cut‐offs and have been based on clinical case series. Methods: We have studied the association between clinical features and age of onse...

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Bibliographic Details
Published in:Movement disorders 2011-02, Vol.26 (3), p.457-463
Main Authors: Wickremaratchi, Mirdhu M., Knipe, M. Duleeka W., Sastry, B.S. Dwarakanath, Morgan, Elizabeth, Jones, Anne, Salmon, Rachel, Weiser, Richard, Moran, Maralyn, Davies, Debbie, Ebenezer, Louise, Raha, Sandip, Robertson, Neil P., Butler, Christopher C., Ben-Shlomo, Yoav, Morris, Huw R.
Format: Article
Language:English
Subjects:
Adult
Age
age at onset
Age Factors
Age of Onset
Aged
Aged, 80 and over
Biological and medical sciences
Cohort Studies
Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases
Dyskinesias - epidemiology
Dyskinesias - etiology
Dystonia - epidemiology
Dystonia - etiology
early onset
Female
Genotype
Genotype & phenotype
Humans
Male
Medical sciences
Middle Aged
Motor Activity - physiology
motor symptoms
Movement disorders
Mutation
Neurology
Parkinson Disease - complications
Parkinson Disease - epidemiology
Parkinson's disease
Phenotype
Prevalence
Severity of Illness Index
young onset
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Summary:Background: Parkinson's disease (PD) is heterogeneous and age at onset may define variation in clinical phenotype. Most previous studies have used various age cut‐offs and have been based on clinical case series. Methods: We have studied the association between clinical features and age of onset in 358 community‐based and regional patients with PD. Results: Tremor at presentation is twice as common in those with onset over 64 years as compared to those with onset under 45 (early onset PD ‐ EOPD) and becomes more common with increasing age at onset (p values for trend ≤ 0.004). Dystonia affects 60% of those with EOPD, shows a curvilinear relationship with age at onset (cubic versus linear p=0.01) with highest risk in patients whose disease began before 48 years. In this study age at onset was a strong predictor of the development of dyskinesias, with younger age associated with a higher risk of dyskinesias. Following multivariable analysis, allowing for possibly confounding factors (disease duration, L‐DOPA dosage, L‐DOPA treatment duration) younger age at onset, (less than 55 years) predicted the development of L‐DOPA induced dyskinesia (odds ratio
ISSN:0885-3185
1531-8257
DOI:10.1002/mds.23469