Parkinsonian signs in older people: prevalence and associations with smoking and coffee

Neurology. 2003 Jul 8;61(1):24-8. doi: 10.1212/01.wnl.0000072330.07328.d6.


Background: Cigarette smoking and coffee consumption may reduce the risk of PD. Parkinsonian signs (tremor, rigidity, bradykinesia) occur in 30 to 40% of the elderly.

Objective: To determine whether there was an association between cigarette smoking, coffee consumption, and parkinsonian signs in a community population of older people.

Methods: Data on smoking were collected and a neurologic examination performed on 1,339 residents > or = 65 years of age in the Washington Heights-Inwood community in northern Manhattan, NY. Parkinsonian signs were rated with an abbreviated Unified Parkinson's Disease Rating Scale, resulting in a parkinsonian sign score. Coffee consumption was assessed with a semiquantitative food-frequency questionnaire, and caffeine consumption was determined. Analyses were cross-sectional.

Results: Mean age was 76.6 years. Parkinsonian signs were present in 537 (40.1%). The odds for presence of parkinsonian signs was lower in smokers than nonsmokers (odds ratio [OR] = 0.58, 95% CI = 0.47 to 0.73). Smokers had a lower mean parkinsonian sign score than nonsmokers (p < 0.001). Coffee drinking and caffeine consumption were not associated with the presence of parkinsonian signs. The odds for presence of parkinsonian signs remained lower in smokers (OR = 0.75, 95% CI = 0.57 to 0.99) after adjusting for age, gender, ethnicity, years of education, adjusted daily caffeine consumption, and dementia.

Conclusion: The reduced risk of parkinsonian signs in cigarette smokers could reflect a protective effect of smoking on age-related parkinsonian signs in the elderly or an aversion to smoking in elderly persons with mild parkinsonism.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Aged
  • Black People / statistics & numerical data
  • Coffee*
  • Comorbidity
  • Cross-Sectional Studies
  • Female
  • Hispanic or Latino / statistics & numerical data
  • Humans
  • Male
  • Neurologic Examination
  • Neuropsychological Tests
  • New York / epidemiology
  • Odds Ratio
  • Parkinsonian Disorders / diagnosis*
  • Parkinsonian Disorders / epidemiology*
  • Prevalence
  • Risk Assessment
  • Smoking / epidemiology*
  • White People / statistics & numerical data


  • Coffee