{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T11:20:58Z","timestamp":1767093658446,"version":"build-2065373602"},"reference-count":25,"publisher":"MDPI AG","issue":"3","license":[{"start":{"date-parts":[[2019,3,23]],"date-time":"2019-03-23T00:00:00Z","timestamp":1553299200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brain Sciences"],"abstract":"<jats:p>Background: The prevalence of dream enactment behavior and other risk factors for a parkinsonian disorder is not well documented. Methods: A survey on prevalence of parkinsonism risk factors was designed using two validated instruments (REM behavior disorder single item question, bowel movement frequency for constipation) and three exploratory instruments (for hallucinations, cognitive and olfactory complaints.) It was sent by mail and email to patients aged 50 and over at two University of Utah community clinics in Salt Lake City. A total of 7888 unique patients were sent the survey, and 1607 responses were recorded (response rate 20%). Those whose age was missing (n = 117) or less than 50 years (n = 10) were excluded from the analysis. Results: Of the 1406 without personal diagnosis of neurodegenerative disease 62.7% were female, and median age was 63. Family history (FH) of Parkinson\u2019s disease was endorsed by 9%, constipation (defined as a bowel movement less than once per day) by 19%, mild cognitive complaints (MCI) 15.8%, dream enactment 13.7%, subjective hyposmia or anosmia 18.2%, and at least one potential psychotic symptom in 37.6%. Multivariable logistic regression showed male gender, mild cognitive complaints, hearing voices, and at least one potentially psychotic symptom to be significantly associated with dream enactment. Conclusions: This survey shows that dream enactment, a strong predictor of risk for synucleinopathy, is relatively common in the older population; because such individuals rarely come to medical attention of a sleep clinic, such survey research may be useful to identify and recruit at-risk individuals for trials aimed at preventing neurodegenerative disease.<\/jats:p>","DOI":"10.3390\/brainsci9030071","type":"journal-article","created":{"date-parts":[[2019,3,27]],"date-time":"2019-03-27T05:03:12Z","timestamp":1553662992000},"page":"71","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Parkinsonism Risk Factors in Salt Lake City, Utah: A Community-Based Study"],"prefix":"10.3390","volume":"9","author":[{"given":"David","family":"Shprecher","sequence":"first","affiliation":[{"name":"Banner Sun Health Research Institute, 10515 W. Santa Fe Drive, Sun City, AZ 85351, USA"},{"name":"Department of Neurology, University of Utah, 175 North Medical Drive East, Salt Lake City, UT 84132, USA"},{"name":"Department of Neurology, University of Arizona, Phoenix, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nan","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Mayo Clinic, Scottsdale, AZ 85259, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew","family":"Halverson","sequence":"additional","affiliation":[{"name":"Huntsman Cancer Institute, University of Utah, Salt Lake City, UT 84112, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rodolfo","family":"Savica","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic, Rochester, MN 55905, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2019,3,23]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1212\/01.wnl.0000341769.50075.bb","article-title":"Incidence and remaining lifetime risk of Parkinson disease in advanced age","volume":"72","author":"Driver","year":"2009","journal-title":"Neurology"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"561","DOI":"10.1093\/ageing\/afi190","article-title":"A systematic review of prevalence and incidence studies of dementia with Lewy bodies","volume":"34","author":"Zaccai","year":"2005","journal-title":"Age Ageing"},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"1296","DOI":"10.1212\/01.wnl.0000340980.19702.6e","article-title":"Quantifying the risk of neurodegenerative disease in idiopathic REM sleep behavior disorder","volume":"72","author":"Postuma","year":"2009","journal-title":"Neurology"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"388","DOI":"10.1212\/WNL.46.2.388","article-title":"Delayed emergence of a parkinsonian disorder in 38% of 29 older men initially diagnosed with idiopathic rapid eye movement sleep behaviour disorder","volume":"46","author":"Schenck","year":"1996","journal-title":"Neurology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"572","DOI":"10.1016\/S1474-4422(06)70476-8","article-title":"Rapid-eye-movement sleep behaviour disorder as an early marker for a neurodegenerative disorder: A descriptive study","volume":"5","author":"Iranzo","year":"2006","journal-title":"Lancet Neurol."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"744","DOI":"10.1016\/j.sleep.2012.10.009","article-title":"Delayed emergence of a parkinsonian disorder or dementia in 81% of older men initially diagnosed with idiopathic rapid eye movement sleep behavior disorder: A 16-year update on a previously reported series","volume":"14","author":"Schenck","year":"2013","journal-title":"Sleep Med."},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Iranzo, A., Fernandez-Arcos, A., Tolosa, E., Serradell, M., Molinuevo, J.L., Valldeoriola, F., Gelpi, E., Vilaseca, I., S\u00e1nchez-Valle, R., and Llad\u00f3, A. (2014). Neurodegenerative disorder risk in idiopathic REM sleep behavior disorder: Study in 174 patients. PLoS ONE, 9.","DOI":"10.1371\/journal.pone.0089741"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"811","DOI":"10.1002\/ana.22282","article-title":"Olfaction and color vision identify impending neurodegeneration in rapid eye movement sleep behavior disorder","volume":"69","author":"Postuma","year":"2011","journal-title":"Ann. Neurol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"1752","DOI":"10.1212\/WNL.0b013e3181c34af5","article-title":"Medical records documentation of constipation preceding Parkinson disease: A case-control study","volume":"73","author":"Savica","year":"2009","journal-title":"Neurology"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"719","DOI":"10.1002\/gps.1966","article-title":"Clinical correlates of Parkinsonian signs in community- dwelling Chinese older persons: A population based study","volume":"23","author":"Tam","year":"2008","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1581","DOI":"10.1002\/mds.21560","article-title":"Bowel movement frequency in late-life and incidental Lewy bodies","volume":"22","author":"Abbott","year":"2007","journal-title":"Mov. Disord."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"167","DOI":"10.1002\/ana.21291","article-title":"Association of olfactory dysfunction with risk for future Parkinson\u2019s disease","volume":"63","author":"Ross","year":"2008","journal-title":"Ann. Neurol."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"119","DOI":"10.1016\/j.jagp.2012.10.010","article-title":"Cognitive decline and dementia risk in older adults with psychotic symptoms: A prospective cohort study","volume":"21","author":"Kohler","year":"2013","journal-title":"Am. J. Geriatr. Psychiatry"},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"S199","DOI":"10.1016\/S1353-8020(11)70062-1","article-title":"Pre-motor features of Parkinson\u2019s disease: The Honolulu-Asia Aging Study experience","volume":"18","author":"Ross","year":"2012","journal-title":"Parkinsonism Relat. Disord."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"893","DOI":"10.1002\/ana.23687","article-title":"Meta-analysis of early nonmotor features and risk factors for Parkinson disease","volume":"72","author":"Noyce","year":"2012","journal-title":"Ann. Neurol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"913","DOI":"10.1002\/mds.25037","article-title":"A single-question screen for rapid eye movement sleep behavior disorder: A multicenter validation study","volume":"27","author":"Postuma","year":"2012","journal-title":"Mov. Disord."},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"456","DOI":"10.1212\/WNL.57.3.456","article-title":"Frequency of bowel movements and the future risk of Parkinson\u2019s disease","volume":"57","author":"Abbott","year":"2001","journal-title":"Neurology"},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"1322","DOI":"10.1002\/gps.4437","article-title":"The prevalence and characteristics of hallucinations, delusions and minor phenomena in a non-demented population sample aged 60 years and over","volume":"31","author":"Soulas","year":"2016","journal-title":"Int. J. Geriatr. Psychiatry"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"102","DOI":"10.1111\/j.1468-1331.2012.03798.x","article-title":"The PRIPS study: Screening battery for subjects at risk for Parkinson\u2019s disease","volume":"20","author":"Berg","year":"2013","journal-title":"Eur. J. Neurol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1070","DOI":"10.1016\/S1474-4422(10)70216-7","article-title":"Decreased striatal dopamine transporter uptake and substantia nigra hyperechogenicity as risk markers of synucleinopathy in patients with idiopathic rapid-eye-movement sleep behaviour disorder: A prospective study [corrected]","volume":"9","author":"Iranzo","year":"2010","journal-title":"Lancet Neurol."},{"key":"ref_21","doi-asserted-by":"crossref","unstructured":"Ma, J.F., Hou, M.M., Tang, H.D., Gao, X., Liang, L., Zhu, L.F., Zhou, Y., Zha, S.Y., Cui, S.S., and Du, J.J. (2016). REM sleep behavior disorder was associated with Parkinson\u2019s disease: A community-based study. BMC Neurol., 16.","DOI":"10.1186\/s12883-016-0640-1"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"101","DOI":"10.1016\/j.sleep.2015.12.016","article-title":"Screening for prodromal Parkinson\u2019s disease in the general community: A sleep-based approach","volume":"21","author":"Postuma","year":"2016","journal-title":"Sleep Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.5665\/sleep.2874","article-title":"REM sleep behavior disorder in the Korean elderly population: Prevalence and clinical characteristics","volume":"36","author":"Kang","year":"2013","journal-title":"Sleep"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"31","DOI":"10.1136\/jnnp-2013-305420","article-title":"PREDICT-PD: Identifying risk of Parkinson\u2019s disease in the community: Methods and baseline results","volume":"85","author":"Noyce","year":"2014","journal-title":"J. Neurol. Neurosurg. Psychiatry"},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1001\/jamaneurol.2017.0985","article-title":"Conversion to Parkinson Disease in the PARS Hyposmic and Dopamine Transporter-Deficit Prodromal Cohort","volume":"74","author":"Jennings","year":"2017","journal-title":"JAMA Neurol."}],"container-title":["Brain Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-3425\/9\/3\/71\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,11]],"date-time":"2025-10-11T12:40:14Z","timestamp":1760186414000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-3425\/9\/3\/71"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,3,23]]},"references-count":25,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2019,3]]}},"alternative-id":["brainsci9030071"],"URL":"https:\/\/doi.org\/10.3390\/brainsci9030071","relation":{},"ISSN":["2076-3425"],"issn-type":[{"type":"electronic","value":"2076-3425"}],"subject":[],"published":{"date-parts":[[2019,3,23]]}}}