Email updates

Keep up to date with the latest news and content from BMC Geriatrics and BioMed Central.

Open Access Research article

Harm avoidance is associated with progression of parkinsonism in community-dwelling older adults: a prospective cohort study

Aron S Buchman12*, Lei Yu1, Robert S Wilson13, Joshua M Shulman45, Patricia A Boyle13 and David A Bennett12

Author Affiliations

1 Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA

2 Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA

3 Department of Behavioral Science, Rush University Medical Center, Chicago, IL, USA

4 Departments of Neurology and Molecular and Human Genetics, Baylor College of Medicine, Houston, TX, USA

5 Jan and Dan Duncan Neurological Research Institute, Houston, TX, USA

For all author emails, please log on.

BMC Geriatrics 2014, 14:54  doi:10.1186/1471-2318-14-54

Published: 23 April 2014

Abstract

Background

We tested the hypothesis that harm avoidance, a trait associated with behavioral inhibition, is associated with the rate of change in parkinsonism in older adults.

Methods

At baseline harm avoidance was assessed with a standard self-report instrument in 969 older people without dementia participating in the Rush Memory and Aging Project, a longitudinal community-based cohort study. Parkinsonism was assessed annually with a modified version of the motor section of the Unified Parkinson’s Disease Rating Scale (mUPDRS).

Results

Average follow-up was 5 years. A linear mixed-effects model controlling for age, sex and education showed that for an average participant (female, 80 years old at baseline, with 14 years of education and a harm avoidance score of 10), the overall severity of parkinsonism increased by about 0.05 unit/ year (Estimate, 0.054, S.E., 0.007, p <0.001) and that the level of harm avoidance was associated with the progression of parkinsonism (Estimate, 0.004, S.E., 0.001, p <0.001). Thus, for an average participant, every 6 point (~1 SD) increase in harm avoidance score at baseline, the rate of progression of parkinsonism increased about 50% compared to an individual with an average harm avoidance score. This amount of change in parkinsonism over the course of the study was associated with about a 5% increased risk of death. The association between harm avoidance and progression of parkinsonism persisted when controlling for cognitive function, depressive symptoms, loneliness, neuroticism, late-life cognitive, social and physical activities and chronic health conditions.

Conclusion

A higher level of the harm avoidance trait is associated with a more rapid progression of parkinsonism in older adults.

Keywords:
Late-life motor impairment; Aging; Parkinsonism; Harm avoidance