Extrapyramidal signs and Alzheimer's disease prognosis in a multiethnic, community-based sample of demented elders

Alzheimers Dement. 2021 Sep;17(9):1465-1473. doi: 10.1002/alz.12309. Epub 2021 Mar 12.

Abstract

Introduction: Extrapyramidal signs (EPS) are a common feature of Alzheimer's disease associated with worse outcomes in observational studies of dementia. Less research has been conducted on ethnic minority and non-clinic-based populations.

Methods: One hundred and forty-two multiethnic community-dwelling participants with dementia were selected. Adjusted Cox models were fitted for mortality, cognitive (Mini Mental State Examination ≤10), functional (Blessed Dementia Rating Scale ≥10), and dependency (needs full-time care) endpoints with baseline EPS as predictor.

Results: Thirty-seven participants (26.06%) had EPS at baseline. EPS predicted more rapid time to death (hazard ratio [HR] = 2.76, 95% confidence interval [CI] = 1.49, 5.42), and functional endpoint (HR = 3.88, 95% CI = 1.75, 8.62) but not cognitive and dependency endpoints. No evidence of interaction by ethnicity, age, sex, education, or apolipoprotein E ε4 polymorphism was found.

Discussion: Our results partially confirm previous studies on predominantly White, clinic-based samples. Further research is needed to better understand the etiological role of EPS in AD.

Keywords: Alzheimer's disease; cognitive impairment; dementia; dependency; extrapyramidal signs; functional impairment; survival analysis.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged, 80 and over
  • Alzheimer Disease / complications*
  • Basal Ganglia Diseases / physiopathology*
  • Ethnic and Racial Minorities*
  • Female
  • Functional Status*
  • Humans
  • Independent Living
  • Male
  • Mental Status and Dementia Tests / statistics & numerical data
  • Prognosis*
  • Prospective Studies