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01.12.2014 | Research article | Ausgabe 1/2014 Open Access

BMC Geriatrics 1/2014

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

Zeitschrift:
BMC Geriatrics > Ausgabe 1/2014
Autoren:
Aron S Buchman, Lei Yu, Robert S Wilson, Joshua M Shulman, Patricia A Boyle, David A Bennett
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1471-2318-14-54) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors’ contributions

ASB, RSW, LY, JMS, PAB, and DAB were involved in the conception, organization and execution of the project. ASB, LY and RSW were involved in the design, execution and review of the statistical analyses. ASB wrote the first draft and RSW, LY, JMS, PAB, and DAB reviewed and critiqued this and subsequent drafts of the manuscript. All authors read and approved the final manuscript. ASB and co-authors had full access to the data, have the right to publish all the data, and have had the right to obtain independent statistical analyses of the data. ASB takes responsibility for the integrity of the data and the accuracy of the data analysis.

Abstract

Background

We tested the hypothesis that harm avoidance, a trait associated with behavioral inhibition, is associated with the rate of change in parkinsonism in older adults.

Methods

At 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).

Results

Average 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.

Conclusion

A higher level of the harm avoidance trait is associated with a more rapid progression of parkinsonism in older adults.
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