Change search
ReferencesLink to record
Permanent link

Direct link
Low muscle strength in late adolescence and Parkinson disease later in life
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Geriatric Medicine.
Umeå University, Faculty of Medicine, Department of Pharmacology and Clinical Neuroscience, Clinical Neuroscience.
Umeå University, Faculty of Medicine, Department of Community Medicine and Rehabilitation, Rehabilitation Medicine.
Umeå University, Faculty of Medicine, Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine.
Show others and affiliations
2015 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 84, no 18, 1862-1869 p.Article in journal (Refereed) Published
Abstract [en]

Objective:To evaluate maximal isometric muscle force at 18 years of age in relation to Parkinson disease (PD) later in life.Methods:The cohort consisted of 1,317,713 men who had their muscle strength measured during conscription (1969-1996). Associations between participants' muscle strength at conscription and PD diagnoses, also in their parents, were examined using multivariate statistical models.Results:After adjustment for confounders, the lowest compared to the highest fifth of handgrip strength (hazard ratio [HR] 1.38, 95% confidence interval [CI] 1.06-1.79), elbow flexion strength (HR 1.34, 95% CI 1.02-1.76), but not knee extension strength (HR 1.24, 95% CI 0.94-1.62) was associated with an increased risk of PD during follow-up. Furthermore, men whose parents were diagnosed with PD had reduced handgrip (fathers: mean difference [MD] -5.7 N [95% CI -7.3 to -4.0]; mothers: MD -5.0 N [95% CI -7.0 to -2.9]) and elbow flexion (fathers: MD -4.3 N [95% CI -5.7 to -2.9]; mothers: MD -3.9 N [95% CI -5.7 to -2.2]) strength, but not knee extension strength (fathers: MD -1.1 N [95% CI -2.9 to 0.8]; mothers: MD -0.7 N [95% CI -3.1 to 1.6]), than those with no such familial history.Conclusions:Maximal upper extremity voluntary muscle force was reduced in late adolescence in men diagnosed with PD 30 years later. The findings suggest the presence of subclinical motor deficits 3 decades before the clinical onset of PD.

Place, publisher, year, edition, pages
2015. Vol. 84, no 18, 1862-1869 p.
National Category
URN: urn:nbn:se:umu:diva-106274DOI: 10.1212/WNL.0000000000001534ISI: 000354104100011PubMedID: 25841033OAI: diva2:841093
Available from: 2015-07-10 Created: 2015-07-09 Last updated: 2016-05-16Bibliographically approved
In thesis
1. Parkinson’s disease: the prodromal phase and consequences with respect to working life
Open this publication in new window or tab >>Parkinson’s disease: the prodromal phase and consequences with respect to working life
2016 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Parkinson’s disease (PD) is a common, progressive neurodegenerative disorder, recognized by the motor symptoms of bradykinesia, tremor, rigidity, and postural impairment. At clinical onset, extensive amounts of dopaminergic neurons have already been lost. The duration of this prodromal phase is uncertain, and it is thought to include predominantly non-motor symptoms. The progressive nature and the symptoms of PD are disabling and reduces the quality of life. Among patients affected in working age, early cessation of employment is common, and such socioeconomic consequences of PD may contribute to an impaired quality of life. The aims of this thesis were to investigate the life situation for people affected by PD in working age, with attention to factors of importance for quality of life and working situation, and to evaluate long-term associations between potential prodromal signs and the later development of PD.Methods: We used a postal survey to investigate the self-perceived life situation among working-aged individuals with PD compared to matched controls, with a specific attention to socioeconomic consequences of disease (paper I). To investigate risk markers preceding the diagnosis of PD (paper II-IV), we used data from nationwide registers. Study II was performed as a cohort study, based on the Swedish Military Service Conscription Register, and study III-IV were performed as nested case-control studies based on a cohort comprising all Swedish citizens aged ≥50 years in 2005.Results: In the survey study (paper I), 38% of the PD participants and 9% of the controls were dissatisfied with life as a whole, and the working situation was an independent risk factor for dissatisfaction with life. In total, 59% of the PD participants had reduced working hours or stopped working due to PD, and many PD participants struggled to cope with their work demands. Support from employer was associated with a higher likelihood to remain employed.We found that low muscle strength in young adulthood, (paper II) and depression (paper III) were associated with an increased risk of PD over follow-up times of more than 2 decades, and that patients with PD were at increased risk of fall-related injuries, hip fractures in particular, a decade or more before the PD diagnosis (paper IV). For depression and fall-related injuries, the association with PD was clearly time-dependent, strongest in the last years before the diagnosis of PD.Conclusions: The results suggest that the prodromal phase of PD may last for more than 2 decades and include also motor symptoms. The consequences of PD include a reduced quality of life associated with the working situation. Employer’s support appear to be particularly important for a successful vocational rehabilitation.

Place, publisher, year, edition, pages
Umeå: Umeå Universitet, 2016. 51 p.
Umeå University medical dissertations, ISSN 0346-6612 ; 1810
Parkinson’s disease, quality of life, employment, rehabilitation, prodromal phase, risk markers, depression, muscle strength, injurious fall, epidemiology
National Category
Geriatrics Neurology
urn:nbn:se:umu:diva-120215 (URN)978-91-7601-479-0 (ISBN)
Public defence
2016-06-10, Vårdvetarhuset, Aulan, Umeå universitet, Umeå, 09:00 (English)
Available from: 2016-05-18 Created: 2016-05-11 Last updated: 2016-05-26Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed

Search in DiVA

By author/editor
Gustafsson, HelenaAasly, JanStråhle, StefanNordström, AnnaNordstrom, Peter
By organisation
Geriatric MedicineClinical NeuroscienceRehabilitation MedicineOccupational and Environmental Medicine
In the same journal

Search outside of DiVA

GoogleGoogle Scholar
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

Altmetric score

Total: 113 hits
ReferencesLink to record
Permanent link

Direct link