Extrapyramidal signs and other neurologic findings in clinically diagnosed Alzheimer's disease. A community-based study
H. H. Funkenstein, M. S. Albert, N. R. Cook, C. G. West, P. A. Scherr, M. J. Chown, D. Pilgrim and D. A. Evans
Department of Neurology, Harvard Medical School, Boston, Mass.
The association between findings on the neurologic examination and the
clinical diagnosis of Alzheimer's disease was investigated among 467
individuals from a geographically defined community population.
Participants were selected by stratified random sampling based on their
memory performance in a population survey of community residents 65 years
of age and older. Each participant underwent a structured medical,
psychiatric, neurologic, and neuropsychologic examination. Of the 467
persons examined there were 134 cases of probable Alzheimer's disease and
167 control subjects. Multiple logistic regression analysis was used to
estimate the degree to which the presence of each of several neurologic
examination findings affected the age- and sex-adjusted relative odds of
having clinically diagnosed Alzheimer's disease. The most striking
associations with the diagnosis of Alzheimer's disease were seen with
various measures of extrapyramidal dysfunction. These increased relative
odds were not markedly affected by excluding from the analysis cases with
severe cognitive impairment. The results suggest that involvement of the
extrapyramidal system is a common finding in Alzheimer's disease.
