Author response: Incident parkinsonism in older adults without Parkinson disease. (28th February 2017)

• Record Type: Journal Article
• Authors: Buchman, Aron S.; Bennett, David A.
• Is Part Of: Neurology. Volume 88:Number 9(2017)
• Page Start: 919
• Page End: 920
• Publication Date: 2017-02-28
• Subjects: Neurology -- Periodicals; Neurology -- Periodicals; Neurologie -- Périodiques; 616.8
• DOI: 10.1212/WNL.0000000000003672
• Languages: English
• ISSNs: 0028-3878

Abstract

Abstract : We thank Mahlknecht et al. for the interest in our study, which reported on risk factors for incident parkinsonism in community-dwelling older adults without Parkinson disease (PD). 1 Mahlknecht et al. confirmed and extended some of our findings, growing the literature that demonstrates that PD, like other chronic diseases of aging, has a long subclinical phase in which brain pathology develops without clinical signs or symptoms, followed by mild signs and symptoms of insufficient severity to warrant a diagnosis of PD, with PD representing a late manifestation. 2 Overall, this conceptual model is similar to the one currently used for Alzheimer disease (AD). 3 However, parkinsonian signs are much more common than subclinical PD pathology and are associated with diverse brain pathologies. 4, 5 Thus, like AD dementia, the clinical phenotype of parkinsonism in older adults may be caused by diverse etiologies. A means for identifying the subset of persons with parkinsonian signs who have PD pathology and are therefore likely to be at a higher risk for progressing to PD is urgently needed.