Extrapyramidal signs in cognitively intact elderly people.

AIM to investigate the prevalence of extrapyramidal signs in elderly people and their relationship to disease. SETTING AND SUBJECTS 151 non-demented subjects age 65 and over living within a defined geographical area in Nottingham who were participating in the MRC multicentre Cognitive Function and Ageing Study. MEASUREMENTS subjects were assessed at home. Extrapyramidal signs were rated according to a standardized neurological examination using items from the Unified Parkinson's Disease Rating Scale. RESULTS bradykinetic and hypokinetic abnormalities are a frequent finding, especially in the oldest old. Over 50% of subjects aged 80 or over demonstrated at least one such sign. Only 10% of subjects had any recorded neurological disease. CONCLUSIONS the frequency of recognized neurological and other disease is insufficient to account for the rate of subtle extrapyramidal abnormalities found. These findings may thus represent intrinsic age-related changes in neurological functioning, this being consistent with previously described pathological changes in the substantia nigra and striatum in normal ageing.