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Parkinsonian signs and cognitive trajectories in older adults : a population-based longitudinal study

Algotsson, Charlotte LU ; Overton, Marieclaire LU ; Basna, Rani LU orcid ; Elmståhl, Sölve LU and Siennicki-Lantz, Arkadiusz LU orcid (2026) In Age and Ageing 55(6).
Abstract

INTRODUCTION: Cognitive impairment is common in parkinsonian disorders, but its extent among older adults with subtle motor abnormalities without a diagnosed movement disorder remains unclear. We examined cognitive decline, domain-specific cognitive function and incident dementia in older adults with subthreshold parkinsonism and parkinsonism (primary analysis). Sensitivity analyses were repeated using an additional definition of Mild Parkinsonian Signs for comparison.

METHODS: In the longitudinal general-population study Good Ageing in Skåne, 398 older adults aged 80-101 years (mean 86) were examined using the Unified Parkinson's Disease Rating Scale part III and a comprehensive cognitive test battery. Participants were followed... (More)

INTRODUCTION: Cognitive impairment is common in parkinsonian disorders, but its extent among older adults with subtle motor abnormalities without a diagnosed movement disorder remains unclear. We examined cognitive decline, domain-specific cognitive function and incident dementia in older adults with subthreshold parkinsonism and parkinsonism (primary analysis). Sensitivity analyses were repeated using an additional definition of Mild Parkinsonian Signs for comparison.

METHODS: In the longitudinal general-population study Good Ageing in Skåne, 398 older adults aged 80-101 years (mean 86) were examined using the Unified Parkinson's Disease Rating Scale part III and a comprehensive cognitive test battery. Participants were followed for a mean of 2.67 (0-9) years. Linear mixed models adjusted for age, sex and education were used to examine cognitive trajectories.

RESULTS: At baseline, 54.4% of participants met the criteria for subthreshold parkinsonism and 23.6% for parkinsonism. Subthreshold parkinsonism was associated with reduced performance in perceptual speed (z-score estimate: -0.51), language (-0.36), executive function (-0.36) and global cognition (-0.33). Parkinsonism was associated with reduced performance in memory (-0.30), perceptual speed (-0.40), language (-0.33), executive function (-0.32) and global cognition (-0.34). Memory decline was most pronounced in both groups. During follow-up, 18% of participants developed dementia; of these, 46% had subthreshold parkinsonism and 26% parkinsonism at baseline.

CONCLUSION: Subthreshold parkinsonism and parkinsonism are associated with cognitive impairment, particularly perceptual speed, language, executive function and global cognition that progress over time. These findings support parkinsonian signs as a prodromal state and highlight the importance of early detection for dementia prevention.

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Please use this url to cite or link to this publication:
author
; ; ; and
organization
publishing date
type
Contribution to journal
publication status
published
subject
in
Age and Ageing
volume
55
issue
6
article number
afag160
publisher
Oxford University Press
external identifiers
  • pmid:42258775
ISSN
1468-2834
DOI
10.1093/ageing/afag160
language
English
LU publication?
yes
additional info
© The Author(s) 2026. Published by Oxford University Press on behalf of the British Geriatrics Society.
id
74374823-aa12-40ac-bb5e-09e2234e8d96
date added to LUP
2026-06-09 12:59:45
date last changed
2026-06-09 13:47:53
@article{74374823-aa12-40ac-bb5e-09e2234e8d96,
  abstract     = {{<p>INTRODUCTION: Cognitive impairment is common in parkinsonian disorders, but its extent among older adults with subtle motor abnormalities without a diagnosed movement disorder remains unclear. We examined cognitive decline, domain-specific cognitive function and incident dementia in older adults with subthreshold parkinsonism and parkinsonism (primary analysis). Sensitivity analyses were repeated using an additional definition of Mild Parkinsonian Signs for comparison.</p><p>METHODS: In the longitudinal general-population study Good Ageing in Skåne, 398 older adults aged 80-101 years (mean 86) were examined using the Unified Parkinson's Disease Rating Scale part III and a comprehensive cognitive test battery. Participants were followed for a mean of 2.67 (0-9) years. Linear mixed models adjusted for age, sex and education were used to examine cognitive trajectories.</p><p>RESULTS: At baseline, 54.4% of participants met the criteria for subthreshold parkinsonism and 23.6% for parkinsonism. Subthreshold parkinsonism was associated with reduced performance in perceptual speed (z-score estimate: -0.51), language (-0.36), executive function (-0.36) and global cognition (-0.33). Parkinsonism was associated with reduced performance in memory (-0.30), perceptual speed (-0.40), language (-0.33), executive function (-0.32) and global cognition (-0.34). Memory decline was most pronounced in both groups. During follow-up, 18% of participants developed dementia; of these, 46% had subthreshold parkinsonism and 26% parkinsonism at baseline.</p><p>CONCLUSION: Subthreshold parkinsonism and parkinsonism are associated with cognitive impairment, particularly perceptual speed, language, executive function and global cognition that progress over time. These findings support parkinsonian signs as a prodromal state and highlight the importance of early detection for dementia prevention.</p>}},
  author       = {{Algotsson, Charlotte and Overton, Marieclaire and Basna, Rani and Elmståhl, Sölve and Siennicki-Lantz, Arkadiusz}},
  issn         = {{1468-2834}},
  language     = {{eng}},
  month        = {{06}},
  number       = {{6}},
  publisher    = {{Oxford University Press}},
  series       = {{Age and Ageing}},
  title        = {{Parkinsonian signs and cognitive trajectories in older adults : a population-based longitudinal study}},
  url          = {{http://dx.doi.org/10.1093/ageing/afag160}},
  doi          = {{10.1093/ageing/afag160}},
  volume       = {{55}},
  year         = {{2026}},
}