Cerebrovascular Disease Pathology and Parkinsonian Signs in Old Age
Open accessAbstract
Background and Purpose—: Mild motor symptoms including parkinsonian signs are common in old age, but their underlying neuropathology is unclear. We tested the hypothesis that cerebrovascular pathologies are related to parkinsonian signs. Methods—: We studied brain autopsies from 418 deceased participants from the Religious Order Study, who underwent evaluation of parkinsonian signs with a modified version of the motor section of the Unified Parkinson's Disease Rating Scale. Brains were evaluated for macroscopic and microinfarcts and the severity of arteriolosclerosis. Regression analyses were used to examine the association of cerebrovascular pathologies with parkinsonian signs. Results—: More than 35% of cases (N=149) showed macroscopic infarcts. Almost 30% of cases without macroscopic infarcts showed pathologies not detected by conventional brain imaging: microinfarcts (N=33 [7.9%]), arteriolosclerosis (N=62 [14.8%]), or both (N=24 [5.7%]). Macroscopic infarcts, specifically multiple cortical and ≥1 subcortical macroscopic infarcts, were related to higher global parkinsonian scores. The presence of multiple and cortical microinfarcts was associated with global parkinsonian score. Arteriolosclerosis was associated with global parkinsonian score, but this effect was attenuated and no longer significant after accounting for infarcts. Each of the 3 pathologies was separately associated with parkinsonian gait (macroscopic infarcts [estimate, 0.552; SE, 0.210; P =0.009]; microinfarcts [estimate, 0.424; SE, 0.213; P =0.047]; arteriolosclerosis [estimate, 0.191; SE, 0.056; P <0.001]). Further analyses showed that subcortical macroscopic and microinfarcts were specifically associated with the severity of parkinsonian gait. Conclusions—: Cerebrovascular pathologies, including macroscopic infarcts, microinfarcts, and arteriolosclerosis, are common in older persons and may be unrecognized common etiologies of mild parkinsonian signs, especially parkinsonian gait, in old age.
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Among 418 non-demented participants of the Religious Order Study (mean age 88.5 ± 5.3 years), only 37.5% were free of any CVD.
“Among 418 non-demented participants of the Religious Order Study (mean age 88.5 ± 5.3 years), 35% showed macroscopic brain infarcts and 14.8% arteriosclerosis, while only 37.5% were free of any CVD [168].”
From The overlap between vascular disease and Alzheimer’s disease - lessons from pathology (2014) · cites this paper as [168]
Among 418 non-demented participants of the Religious Order Study (mean age 88.5 ± 5.3 years), 35% showed macroscopic brain infarcts.
“Among 418 non-demented participants of the Religious Order Study (mean age 88.5 ± 5.3 years), 35% showed macroscopic brain infarcts and 14.8% arteriosclerosis, while only 37.5% were free of any CVD [168].”
From The overlap between vascular disease and Alzheimer’s disease - lessons from pathology (2014) · cites this paper as [168]
Among 418 non-demented participants of the Religious Order Study (mean age 88.5 ± 5.3 years), 14.8% showed arteriosclerosis.
“Among 418 non-demented participants of the Religious Order Study (mean age 88.5 ± 5.3 years), 35% showed macroscopic brain infarcts and 14.8% arteriosclerosis, while only 37.5% were free of any CVD [168].”
From The overlap between vascular disease and Alzheimer’s disease - lessons from pathology (2014) · cites this paper as [168]
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- Authors
- Buchman, A. S., Leurgans, S. E., Nag, S., Bennett, D. A., & Schneider, J. A.
- Affiliations
- Rush University Medical Center (US)
- Venue
- Stroke
- Published
- 2011-11
- Volume
- 42
- Issue
- 11
- Pages
- 3183-3189
- ISSN
- 0039-2499 (ISSN-L)
- 1524-4628
- PMC
- PMC3202031
- OpenAlex
- W2148903189
- Cited by
- 133
- References
- 31
- Citations by year
- 2026: 7 · 2025: 10 · 2024: 8 · 2023: 15 · 2022: 6 · 2021: 14 · 2020: 8 · 2019: 10 · 2018: 7 · 2017: 9 · 2016: 15 · 2015: 2 · 2014: 13 · 2013: 3 · 2012: 5
- FWCI
- 4.46
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Stroke (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute on Aging (P30-AG 10161, R01-AG-24480, R01 AG15819, R01AG015819, P30AG010161, R01AG024480)
- Topics
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Health Sciences › Medicine › Neurology › Cerebrovascular and genetic disorders
- Keywords
- parkinsonian signs, cerebrovascular disease, microinfarcts, arteriolosclerosis, parkinsonian gait, older adults, neuropathology, Unified Parkinson's Disease Rating Scale, cortical infarction, subcortical infarcts
- MeSH terms
- Aged, 80 and over, Aging, Brain, Cerebrovascular Disorders, Female, Follow-Up Studies, Humans, Male, Parkinson Disease
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