{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T11:07:26Z","timestamp":1788865646492,"version":"build-2803163510"},"reference-count":41,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T00:00:00Z","timestamp":1788825600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["movementdisorders.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Movement Disord Clin Pract"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      Population\u2010based data on mild parkinsonian signs (\n                      <jats:styled-content style=\"fixed-case\">MPS<\/jats:styled-content>\n                      ) and parkinsonism in nonagenarians are scarce.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>\n                      To estimate the prevalence of\n                      <jats:styled-content style=\"fixed-case\">MPS<\/jats:styled-content>\n                      , definite parkinsonism, and broader parkinsonian motor phenotypes; assess\n                      <jats:styled-content style=\"fixed-case\">MPS<\/jats:styled-content>\n                      after excluding idiopathic Parkinson disease and definite parkinsonism; and examine associations with sex and dementia in a cohort of nonagenarians.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      This cross\u2010sectional analysis included 144 participants from the Neurological Disorders in Central Spain (\n                      <jats:styled-content style=\"fixed-case\">NEDICES<\/jats:styled-content>\n                      ) cohort aged \u226590\u2009years on May 1, 1999; 97 were examined, and 47 had reliable indirect information. Unified Parkinson's Disease Rating Scale (\n                      <jats:styled-content style=\"fixed-case\">UPDRS<\/jats:styled-content>\n                      ) motor data were evaluable in 96 of the examined participants. MPS were classified using established UPDRS\u2010based operational criteria. Definite parkinsonism was defined primarily by a bradykinesia score \u22652 plus rigidity \u22651 or rest tremor \u22651; participants with an established Parkinson's disease diagnosis receiving antiparkinsonian treatment were also retained as definite cases when supported by prior clinical documentation. Bradykinesia \u22652 plus postural instability \u22652 in the absence of rest tremor and rigidity defined an instability\u2010defined phenotype. Wilson's 95% confidence intervals (\n                      <jats:styled-content style=\"fixed-case\">CIs)<\/jats:styled-content>\n                      and two\u2010sided Fisher's exact tests were used.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      <jats:styled-content style=\"fixed-case\">MPS<\/jats:styled-content>\n                      were present in 90\/96 participants (93.8%; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 87.0\u201397.1%). Prevalence remained 93.4% (85\/91; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 86.4\u201396.9%) after excluding idiopathic Parkinson's disease and 92.6% (75\/81; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 84.8\u201396.6%) after excluding all 15 examined definite cases. Definite parkinsonism affected 16\/144 participants (11.1%; 95%\n                      <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content>\n                      , 7.0\u201317.3%), including 5 with idiopathic Parkinson's disease (3.5%; 95% CI, 1.5\u20137.9%). Among the 96 UPDRS\u2010evaluable participants, 15 had definite parkinsonism, 7 additional participants had instability\u2010defined parkinsonism, and inclusion of uncertain phenotypes expanded the broader parkinsonian motor spectrum to 63\/96 (65.6%; 95% CI, 55.7%\u201374.4%). Dementia was more frequent with definite parkinsonism (13\/16 vs 28\/128;\n                      <jats:italic>P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Definite parkinsonism did not differ by sex; rest tremor was more frequent in men (\n                      <jats:italic>P<\/jats:italic>\n                      \u2009=\u2009.006).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Parkinsonian motor features were frequent and phenotypically diverse among nonagenarians with evaluable UPDRS motor assessments. Definite parkinsonism represented only part of the broad parkinsonian motor spectrum, and idiopathic Parkinson's disease comprised only a small proportion of definite cases. These findings should not be interpreted either as synonymous with Parkinson's disease or as merely reflecting normal aging<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/mdc3.70802","type":"journal-article","created":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:14:53Z","timestamp":1788862493000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Parkinsonian Motor Spectrum in Nonagenarians: A Population\u2010Based Study"],"prefix":"10.1002","author":[{"given":"Ver\u00f3nica","family":"Domingo","sequence":"first","affiliation":[{"name":"Department of Geriatrics Gregorio Mara\u00f1\u00f3n University Hospital  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5413-232X","authenticated-orcid":false,"given":"F\u00e9lix","family":"Bermejo\u2010Pareja","sequence":"additional","affiliation":[{"name":"Group of Neurodegenerative Diseases Hospital Universitario 12 de Octubre Research Institute  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2062-362X","authenticated-orcid":false,"given":"Elan D.","family":"Louis","sequence":"additional","affiliation":[{"name":"Department of Neurology University of Texas Southwestern Medical Center  Dallas Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda Elena","family":"Carrillo","sequence":"additional","affiliation":[{"name":"Department of Geriatrics Guadarrama University\u2010Affiliated Hospital  Guadarrama Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3086-4024","authenticated-orcid":false,"given":"\u00c1lex","family":"Escol\u00e0\u2010Gasc\u00f3n","sequence":"additional","affiliation":[{"name":"Blanquerna Foundation, Ramon Llull University  Barcelona Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1769-4809","authenticated-orcid":false,"given":"Juli\u00e1n","family":"Benito\u2010Le\u00f3n","sequence":"additional","affiliation":[{"name":"Group of Neurodegenerative Diseases Hospital Universitario 12 de Octubre Research Institute  Madrid Spain"},{"name":"Department of Neurology 12 de Octubre University Hospital  Madrid Spain"},{"name":"Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED)  Madrid Spain"},{"name":"Department of Medicine, Faculty of Medicine Complutense University of Madrid  Madrid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,9,8]]},"reference":[{"key":"e_1_2_10_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(23)01419-8"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(24)00038-3"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2024-080952"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11940-021-00665-5"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.63.5.717"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.28777"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199601113340202"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1001\/archneur.61.8.1273"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.20735"},{"key":"e_1_2_10_11_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000156157.97411.5E"},{"key":"e_1_2_10_12_1","doi-asserted-by":"publisher","DOI":"10.1161\/STROKEAHA.112.657130"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004842"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/gerona\/glv153"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000007315"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000207497"},{"key":"e_1_2_10_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2023.105416"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.puhe.2003.10.007"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.33588\/rn.4607.2008134"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.10362"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1212\/01.WNL.0000113727.73153.68"},{"key":"e_1_2_10_22_1","first-page":"153","volume-title":"Recent Developments in Parkinson's Disease","author":"Fahn S","year":"1987"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.1177\/0891988709335794"},{"key":"e_1_2_10_24_1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"1994"},{"key":"e_1_2_10_25_1","volume-title":"Diagnostic and Statistical Manual of Mental Disorders","author":"American Psychiatric Association","year":"1987"},{"key":"e_1_2_10_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.55.3.181"},{"key":"e_1_2_10_27_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.26424"},{"key":"e_1_2_10_28_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000004058"},{"key":"e_1_2_10_29_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.21507"},{"key":"e_1_2_10_30_1","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1097-0258(19980430)17:8<857::AID-SIM777>3.0.CO;2-E"},{"key":"e_1_2_10_31_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61602-X"},{"key":"e_1_2_10_32_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000001866"},{"key":"e_1_2_10_33_1","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.17.5.427"},{"key":"e_1_2_10_34_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.61.6.645"},{"key":"e_1_2_10_35_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.prdoa.2021.100095"},{"key":"e_1_2_10_36_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMra2301292"},{"key":"e_1_2_10_37_1","doi-asserted-by":"publisher","DOI":"10.1136\/jnnp.62.1.10"},{"key":"e_1_2_10_38_1","doi-asserted-by":"publisher","DOI":"10.1002\/mds.27277"},{"key":"e_1_2_10_39_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41531-022-00280-4"},{"key":"e_1_2_10_40_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.parkreldis.2017.06.018"},{"key":"e_1_2_10_41_1","doi-asserted-by":"publisher","DOI":"10.3390\/jcm14020498"},{"key":"e_1_2_10_42_1","doi-asserted-by":"publisher","DOI":"10.33588\/rn.6604.2017440"}],"container-title":["Movement Disorders Clinical Practice"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70802","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/mdc3.70802","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/mdc3.70802","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T10:14:54Z","timestamp":1788862494000},"score":1,"resource":{"primary":{"URL":"https:\/\/movementdisorders.onlinelibrary.wiley.com\/doi\/10.1002\/mdc3.70802"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9,8]]},"references-count":41,"alternative-id":["10.1002\/mdc3.70802"],"URL":"https:\/\/doi.org\/10.1002\/mdc3.70802","archive":["Portico"],"relation":{},"ISSN":["2330-1619","2330-1619"],"issn-type":[{"value":"2330-1619","type":"print"},{"value":"2330-1619","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,8]]},"assertion":[{"value":"2026-05-22","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-08-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-09-08","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"mdc3.70802"}}