Objective: To assess the prevalence of risk factors for parkinsonism in Salt Lake City (SLC), Utah.

Background: Recent data suggest that non-motor symptoms including constipation, olfactory dysfunction, and dream enactment behavior (DEB) may predate diagnosis of Parkinson’s disease, Lewy body dementia and related synucleinopathies by many years. Therefore, a premanifest state may exist for these disorders, allowing a potential window for neuroprotective intervention to prevent (or delay) the onset of disease. In order to guide design of future trials, we used a survey on prevalence of these risk factors in SLC.

Methods: A survey on parkinsonism risk factors was designed using two validated instruments (REM behavior disorder single item question for DEB and bowel movement frequency for constipation) and exploratory items for hallucinations, cognitive and olfactory complaints. The survey was sent by mail and (where available) email to patients aged 50+ from two large primary care clinics in the University Healthcare network. Duplicate records were identified as having matching zip code and birth date for the respondent; the most recent survey record was kept in these cases.

Results: A total of 7,888 unique patients were sent the survey; 1,344 responded (17%). Of these, 1242 without personal diagnosis of neurodegenerative disease (ND) were included in the analysis. These respondents were 62.4% female, mean age 65. Family history (FH) of ND was endorsed by 35.7%, constipation (defined as a bowel movement less than once per day) 35.6%, mild cognitive complaints (MCI) 14%, DEB 13%, subjective hyposmia or anosmia 12%. Of those with positive FH, 8% endorsed DEB, 21% MCI, 16% constipation, 18.1% hyposmia/anosmia. Potential psychotic symptoms were follows. 6% of all respondents endorsed visual, 7% auditory, 4% sensed presence, 8% tactile hallucinations; 4% paranoid thoughts, 5% perceived as paranoid by others. 5% of respondents with positive FH endorsed visual, 9% auditory, 4% sensed presence hallucinations; 3% paranoid thoughts, 4% perceived as paranoid by others.

Conclusions: This survey shows that DEB, as well as other less specific risk factors for synucleinopathy, are relatively common in the older population. Because individuals with DEB rarely come to medical attention of a sleep clinic, this type of survey research may serve as a more effective mechanism to screen and recruit eligible individuals for trials aimed at preventing neurodegenerative disease.

« Back to 2016 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/parkinsonism-risk-factors-in-salt-lake-city-utah/