Skip to main content Accessibility help
×
Home

Prevalence, incidence and risk factors of paratonia in patients with dementia: a one-year follow-up study

Published online by Cambridge University Press:  27 January 2011

Johannes S. M. Hobbelen
Affiliation:
Dutch Institute of Allied Health Care, Amersfoort, The Netherlands Maastricht University, Research School CAPHRI, Maastricht, The Netherlands The Maastricht Institute of Mental Health and Neurosciences/Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands Department of Epidemiology, Maastricht University, Maastricht, The Netherlands Institute for Human Movement Studies, Department of Physiotherapy, University of Applied Sciences Utrecht, The Netherlands
Frans E. S. Tan
Affiliation:
Maastricht University, Research School CAPHRI, Maastricht, The Netherlands Department of Methodology and Statistics, Maastricht University, The Netherlands
Frans R. J. Verhey
Affiliation:
The Maastricht Institute of Mental Health and Neurosciences/Alzheimer Center Limburg, Maastricht University, Maastricht, The Netherlands Maastricht University Hospital / Alzheimer Center, Limburg, The Netherlands
Raymond T. C. M. Koopmans
Affiliation:
Department of Primary and Community Care. Center for Family Medicine, Geriatric Care and Public Health, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
Rob A. de Bie
Affiliation:
Maastricht University, Research School CAPHRI, Maastricht, The Netherlands Department of Epidemiology, Maastricht University, Maastricht, The Netherlands
Corresponding

Abstract

Background: Paratonia is a progressive motor problem that is observed in individuals with dementia and is not a well-known phenomenon. This study explores the development and risk factors of paratonia in moderate stage dementia patients.

Methods: A multi-center, longitudinal, one-year follow-up cohort study was performed. Patients with an established diagnosis of dementia, with a score of 6 or lower on the Global Deterioration Scale (GDS) were included. The participants were assessed using the Paratonia Assessment Instrument (PAI), the Timed Up and GO test, the Qualidem, the Global Deterioration Scale (Reisberg et al., 1982) and the Mini-mental State Examination. Information about each patient's diagnosis of dementia, comorbidities and use of medication were obtained from the participant's medical file. The PAI was assessed every three months, the other variables at baseline and after 12 months. Cross-tabulation χ2 and logistic regression tests were used for the statistical analyses.

Results: Baseline measures were assessed in the 204 participants – 111 (54%) female and 93 (46%) male, with a mean age of 79.8 years (56–97). Seventy-one patients (34.8%) were diagnosed with paratonia at baseline, and 51 patients developed paratonia over one year. The highest hazard ratio (3.1) for developing paratonia within one year was observed in the vascular dementia group. The logistic regression analysis revealed that the presence of diabetes mellitus (OR = 10.7) was significantly related to the development of paratonia (Wald χ2 p-value < 0.01).

Conclusions: Diabetes mellitus and likely vascular damage are risk factors for the development of paratonia.

Type
Research Article
Copyright
Copyright © International Psychogeriatric Association 2011

Access options

Get access to the full version of this content by using one of the access options below.

References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Washington, DC: American Psychiatric Association.Google ScholarPubMed
Araki, A. and Ito, H. (2009). Diabetes mellitus and geriatric syndromes.Geriatrics and Gerontology International, 9, 105114.CrossRefGoogle ScholarPubMed
Arvanitakis, Z., Wilson, R. S., Schneider, J. A., Bienias, J. L., Evans, D. A. and Bennett, D. A. (2004). Diabetes mellitus and progression of rigidity and gait disturbance in older persons. Neurology, 63, 9961001.CrossRefGoogle ScholarPubMed
Arvanitakis, Z., Wilson, R. S., Bienias, J. L. and Bennett, D. A. (2007). Diabetes and parkinsonian signs in older persons. Alzheimer Disease and Associated Disorders, 21, 144149.CrossRefGoogle ScholarPubMed
Beversdorf, D. Q. and Heilman, K. M. (1998). Facilitory paratonia and frontal lobe functioning. Neurology, 51, 968971.CrossRefGoogle ScholarPubMed
Chodzko-Zajko, W. J. et al. (2009). American College of Sports Medicine position stand: exercise and physical activity for older adults. Medicine and Science in Sports and Exercise, 41, 15101530.CrossRefGoogle ScholarPubMed
Ettema, T. P., Droes, R. M., de Lange, J., Mellenbergh, G. J. and Ribbe, M. W. (2007). QUALIDEM: development and evaluation of a dementia specific quality of life instrument – validation. International Journal of Geriatric Psychiatry, 22, 424430.CrossRefGoogle ScholarPubMed
Folstein, M. F., Folstein, S. E. and McHugh, P. R. (1975). “Mini-mental state”: a practical method for grading the cognitive state of patients for the clinician. Journal of Psychiatry Research, 12, 189198.CrossRefGoogle ScholarPubMed
Franssen, E. H., Kluger, A., Torossian, C. L. and Reisberg, B. (1993). The neurologic syndrome of severe Alzheimer's disease: relationship to functional decline. Archives of Neurology, 50, 10291039.CrossRefGoogle ScholarPubMed
Hobbelen, J., de Bie, R. and van Rossum, E. (2003). Effect of passive movement on severity of paratonia: a partially blinded, randomized clinical trial. Nederlands Tijdschrift voor Fysiotherapie, 113, 132137.Google Scholar
Hobbelen, J. S., Koopmans, R. T., Verhey, F. R., van Peppen, R. P. and de Bie, R. A. (2006). Paratonia: a delphi procedure for consensus definition. Journal of Geriatric Physical Therapy, 29, 5056.CrossRefGoogle ScholarPubMed
Hobbelen, J. S., Koopmans, R. T., Verhey, F. R., Habraken, K. M. and de Bie, R. A. (2008). Diagnosing paratonia in the demented elderly: reliability and validity of the Paratonia Assessment Instrument (PAI). International Psychogeriatrics, 20, 840852.CrossRefGoogle Scholar
Kurlan, R., Richard, I. H., Papka, M. and Marshall, F. (2000). Movement disorders in Alzheimer's disease: more rigidity of definitions is needed. Movement Disorders, 15, 2429.3.0.CO;2-X>CrossRefGoogle ScholarPubMed
McKeith, I. G. et al. (1996). Consensus guidelines for the clinical and pathologic diagnosis of dementia with Lewy bodies (DLB): report of the consortium on DLB international workshop. Neurology, 47, 11131124.CrossRefGoogle Scholar
McKhann, G., Drachman, D., Folstein, M., Katzman, R., Price, D. and Stadlan, E. M. (1984). Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of Department of Health and Human Services Task Force on Alzheimer's Disease. Neurology, 34, 939944.CrossRefGoogle ScholarPubMed
Mourey, F., Manckoundia, P., Martin-Arveux, I., Tavernier-Vidal, B. and Pfitzenmeyer, P. (2004). Psychomotor disadaptation syndrome: a new clinical entity in geriatric patients. Geriatrics, 59, 2024.Google ScholarPubMed
O'Keeffe, S. T., Kazeem, H., Philpott, R. M., Playfer, J. R., Gosney, M. and Lye, M. (1996). Gait disturbance in Alzheimer's disease: a clinical study. Age and Ageing, 25, 313316.CrossRefGoogle ScholarPubMed
Podsiadlo, D. and Richardson, S. (1991). The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. Journal of the American Geriatrics Society, 39, 142148.CrossRefGoogle Scholar
Prehogan, A. and Cohen, C. I. (2004). Motor dysfunction in dementias. Geriatrics, 59, 5360.Google ScholarPubMed
Reisberg, B., Ferris, S. H., de Leon, M. J. and Crook, T. (1982). The Global Deterioration Scale for assessment of primary degenerative dementia. American Journal of psychiatry, 139, 11361139.Google Scholar
Ries, J. D., Echternach, J. L., Nof, L. and Gagnon Blodgett, M. (2009). Test-retest reliability and minimal detectable change scores for the timed “up & go” test, the six-minute walk test, and gait speed in people with Alzheimer disease. Physical Therapy, 89, 569579.CrossRefGoogle Scholar
Risse, S. C. et al. (1990). Myoclonus, seizures, and paratonia in Alzheimer disease. Alzheimer Disease and Associated Disorders, 4, 217225.CrossRefGoogle ScholarPubMed
Román, G. C. et al. (1993). Vascular dementia: diagnostic criteria for research studies. Report of the NINDS-AIREN International Workshop. Neurology, 43, 250260.CrossRefGoogle ScholarPubMed
Sigal, R. J., Kenny, G. P., Wasserman, D. H., Castaneda-Sceppa, C. and White, R. D. (2006). Physical activity/exercise and type 2 diabetes: a consensus statement from the American Diabetes Association. Diabetes Care, 29, 14331438.CrossRefGoogle ScholarPubMed
Skrbo, A., Begović, B. and Skrbo, S. (2004). [Classification of drugs using the ATC system and the latest changes]. Medicinski Arhive, 58 (Suppl. 2), 138141.Google Scholar
Soininen, H., Laulumaa, V., Helkala, E. L., Hartikainen, P. and Riekkinen, P. J. (1992). Extrapyramidal signs in Alzheimer's disease: a 3-year follow-up study. Journal of Neural Transmission, 4, 107119.CrossRefGoogle ScholarPubMed
Sonnen, J. A. et al. (2009). Different patterns of cerebral injury in dementia with or without diabetes. Archives of Neurology, 66, 315322.CrossRefGoogle ScholarPubMed
Souren, L. E., Franssen, E. H. and Reisberg, B. (1997). Neuromotor changes in Alzheimer's disease: implications for patient care. Journal of Geriatric Psychiatry and Neurology, 10, 9398.CrossRefGoogle Scholar
Stevens, T., Livingston, G., Kitchen, G., Manela, M., Walker, Z. and Katona, C. (2002). Islington study of dementia subtypes in the community. British Journal of Psychiatry, 180, 270276.CrossRefGoogle Scholar
Tyrrell, P. J. et al. (1990). Clinical and positron emission tomographic studies in the “extrapyramidal syndrome” of dementia of the Alzheimer type. Archives of Neurology, 47, 13181323.CrossRefGoogle Scholar
Ulrich, P. and Cerami, A. (2001). Protein glycation, diabetes, and aging. Recent Progress in Hormone Research, 56, 121.CrossRefGoogle ScholarPubMed
Vahia, I., Cohen, C. I., Prehogan, A. and Memon, Z. (2007). Prevalence and impact of paratonia in Alzheimer disease in a multiracial sample. American Journal of Geriatric Psychiatry, 15, 351353.CrossRefGoogle Scholar

Altmetric attention score

Full text views

Full text views reflects PDF downloads, PDFs sent to Google Drive, Dropbox and Kindle and HTML full text views.

Total number of HTML views: 9
Total number of PDF views: 108 *
View data table for this chart

* Views captured on Cambridge Core between September 2016 - 27th January 2021. This data will be updated every 24 hours.

Hostname: page-component-898fc554b-p5tlp Total loading time: 0.654 Render date: 2021-01-27T01:49:14.210Z Query parameters: { "hasAccess": "0", "openAccess": "0", "isLogged": "0", "lang": "en" } Feature Flags: { "shouldUseShareProductTool": true, "shouldUseHypothesis": true, "isUnsiloEnabled": true, "metricsAbstractViews": false, "figures": false, "newCiteModal": false }

Send article to Kindle

To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Prevalence, incidence and risk factors of paratonia in patients with dementia: a one-year follow-up study
Available formats
×

Send article to Dropbox

To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

Prevalence, incidence and risk factors of paratonia in patients with dementia: a one-year follow-up study
Available formats
×

Send article to Google Drive

To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

Prevalence, incidence and risk factors of paratonia in patients with dementia: a one-year follow-up study
Available formats
×
×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *