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Diabetes and Parkinsonian Signs in Older Persons

Arvanitakis, Zoe MD* †; Wilson, Robert S. PhD* ‡; Bienias, Julia L. ScD§ ∥; Bennett, David A. MD* †

Alzheimer Disease & Associated Disorders: April-June 2007 - Volume 21 - Issue 2 - p 144-149
doi: 10.1097/WAD.0b013e31805ba768
Original Articles

We examined the relation of type 2 diabetes mellitus to parkinsonian signs in older persons. Participants were 1030 women and men (mean age 80.3 y, education 14.5 y, Mini-Mental State Examination 27.9) without dementia or Parkinson disease, enrolled in the Rush Memory and Aging Project, an epidemiologic study of aging. We used separate linear and logistic regression models, adjusted for age, sex, and education, to examine the relation of diabetes, identified by history and medication inspection, to each of the scores of global parkinsonian signs and 4 separate parkinsonian signs. Diabetes was present in 140 (14%) participants. Most participants had mild parkinsonian signs. Diabetes was associated with a more severe global parkinsonian signs score (=0.20, SE=0.10, P=0.05) and postural reflex impairment-gait disturbance (=0.40, SE=0.17, P=0.02), but not with bradykinesia, rigidity, or tremor. Associations were no longer significant after controlling for vascular risk factors or conditions, particularly body mass index and congestive heart failure. Overall, there was no evidence that vascular variables modified the relation of diabetes to parkinsonian signs. In summary, we found that diabetes was associated with parkinsonian signs, especially postural reflex impairment-gait disturbance, and that vascular factors may play a role in this association.

*Rush Alzheimer's Disease Center

Department of Neurological Sciences

Department of Behavioral Sciences

§Rush Institute for Healthy Aging

Department of Internal Medicine, Rush University Medical Center, Chicago, IL

Supported by the National Institute on Aging grants K23 AG23675 and R01 AG17917, and the Illinois Department of Public Health.

Reprints: Zoe Arvanitakis, MD, Rush Alzheimer's Disease Center, Rush University Medical Center, 600 South Paulina Street, Suite 1020; Chicago, IL 60612.

Received for publication August 8, 2006; accepted February 15, 2007

© 2007 Lippincott Williams & Wilkins, Inc.