Elderly people who complain of stiffness, loss of balance and tremors may be at increased risk for future Parkinson's disease.

The study is published in the Archives of Neurology.

Parkinson's disease develops over time as neurons in certain areas of the brain that control muscle movement slowly waste away.
The degeneration occurs in areas that produce a neurotransmitter known as dopamine.
Typical symptoms of Parkinson's disease, including severe tremors, rigidity and slow movements, begin when the brain loses more than half of its dopamine production ability.

Lonneke M. L. de Lau, and colleagues at the Erasmus Medical Center, Rotterdam, the Netherlands, hypothesized that individuals who were developing Parkinson's disease might experience some other, milder symptoms before clinically recognizable symptoms of Parkinson's disease occur.

They examined 6,038 elderly people who did not have Parkinson's disease or dementia.
The participants answered questions about their motor skills, including whether they had experienced stiffness, tremors, falling, slowness or a feeling of imbalance.
More than half of them reported at least one of these complaints.
They were then assessed for Parkinson's disease at two follow-up visits and their medical records were analyzed.

Over the course of the study, which followed participants for an average of 5.8 years, people who had initially reported stiffness, tremors or imbalance were more likely to develop Parkinson's disease than those who had not.
Of the 56 people who developed Parkinson's disease during the study, 71.8 percent had reported at least one motor complaint and 41 percent at least two.

" Our findings support the notion that clinically manifest Parkinson's disease is preceded by a preclinical phase that is not entirely asymptomatic," the authors report. " Subjective complaints related to motor function might indicate a very early phase of not-yet-diagnosable Parkinson's disease during which dopamine loss is not sufficient to produce overt typical Parkinson's disease symptoms but may result in subtle signs that are very mild or only intermittently present and therefore not likely to be detected in routine screening or examination."

Since such a large percentage of elderly people report these motor symptoms and a relatively small percentage of them go on to develop Parkinson's disease, it's unlikely that screening for these complaints alone would be effective in detecting the disease, the authors report. However, as researchers continue work to pinpoint biological markers of Parkinson's disease, assessing these types of complaints might help narrow down candidates for brain imaging, psychological testing or other methods of early diagnosis, they conclude.

Source: American Medical Association, 2006


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