Clinical Epidemiology, Evaluation, and Management of Dementia in Parkinson Disease

Safarpour, Delaram; Willis, Allison W.

doi:10.1177/1533317516653823

Cited by 17 publications

(15 citation statements)

References 89 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Traditional treatments such as physical cognitiving exercises, pharmacotherapy, and cognitive therapy are still controversial and need further confirmation. Some of these therapies may cause a series of side effects such as nausea, vomiting and aggravating symptoms of exercise [11]. Therefore, identifying safe therapies to alleviate symptoms remains a priority.…”

mentioning

confidence: 99%

Effect of rTMS on Parkinson's Cognitive Function: A Systematic Review and Meta-analysis

Jiang

McClure

et al. 2020

Preprint

View full text Add to dashboard Cite

Background: To evaluate the effects and optimal parameters of repetitive transcranial magnetic stimulation (rTMS) on cognition function of Parkinson's disease (PD) patients and to estimate which cognitive function may obtain more benefits from rTMS. Method: The articles dealing with rTMS on cognition of PD patients were retrieved from the databases until April 2019. Two researchers selected research papers, evaluated their quality, extracted data, and cross-checked them according to the inclusion and exclusion criteria. The standardized mean differences (SMDs) with 95 % confidence interval (CI) of cognitive outcome for different parameters, scales, and cognitive functions were estimated. Results: Fourteen studies involving 173 subjects were included in the study. A significant effect size was observed with the mini-mental state examination (MMSE) for the global cognitive outcome based on the evidence of four published articles. Further subtests for different cognitive domains demonstrated prominent effect for the executive function. The significant effect sizes for executive function were found with multiple sessions of high-frequency rTMS over frontal cortex, especially over dorsolateral prefrontal cortex (DLPFC). All of the other cognitive domains including memory, attention, and language ability did not obtain significant effects. Conclusions: Multiple sessions of high-requency rTMS over the DLPFC may have positive effect on executive function in PD patients. Further well designed studies with large sample sizes are needed to verify our results and ascertain the long-term effects of rTMS.

show abstract

mentioning

confidence: 99%

Effect of rTMS on Parkinson's Cognitive Function: A Systematic Review and Meta-analysis

Jiang

McClure

et al. 2020

Preprint

View full text Add to dashboard Cite

show abstract

“…Parkinson's disease (PD) is the second most common neurodegenerative disorder accompanied by motor symptoms (bradykinesia, rigidity, and resting tremor) and nonmotor symptoms . Cognitive impairment is one of the most common and devastating nonmotor features in the PD population, which covers Parkinson's disease with dementia (PDD), Parkinson's disease with mild cognitive impairment (PD‐MCI), and some unclearly classified cognitive impairment. PD‐MCI refers to a transitional stage between normal aging and dementia .…”

mentioning

confidence: 99%

Modifiable risk factors for cognitive impairment in Parkinson's disease: A systematic review and meta‐analysis of prospective cohort studies

Guo

Liu

et al. 2019

Movement Disorders

View full text Add to dashboard Cite

A BS TRACT: Background: Cognitive impairment is a common and devastating manifestation in Parkinson's disease (PD). We aimed to identify modifiable risk factors for PD with cognitive impairment. Methods: We systematically searched PubMed and the Cochrane Library from June 1937 to September 2018 and included prospective cohort studies with random-effects model used to combine estimates. Primary analyses for all types of cognitive impairments and subgroup analyses for separate outcomes were conducted. Results: A total of 31,298 articles were identified, of which 32 articles with 18 factors met the inclusion criteria for meta-analysis. In the primary analysis, 9 modifiable risk factors were found to increase the risk of PD with cognitive impairment, including postural-instability-gait disorder (relative risk = 3.76, 95% confidence interval = 1.36-10.40), hallucinations (relative risk = 3.09, 95% confidence interval = 1.61-5.93), orthostatic hypotension (relative risk = 2.98, 95% confidence interval = 1.41-6.28), cerebrovascular disease (relative risk = 1.52, 95% confidence interval = 1.01-2.28), diabetes mellitus (relative risk = 1.47, 95% confidence interval = 1.13-1.92), obesity (relative risk = 1.38, 95% confidence interval = 1.15-1.65), cardiac disease (relative risk = 1.35, 95% confidence interval = 1.17-1.56), alcohol consumption (relative risk = 1.32, 95% confidence interval = 1.15-1.52), and smoking (relative risk = 1.31, 95% confidence interval = 1.14-1.50). In the subgroup analysis, postural-instability-gait disorder subtype, orthostatic hypotension and hallucinations may increase the risk of dementia in PD. A total of 37 articles were included in the systematic review, in which 9 risk factors and 1 protective factor were additionally associated in single studies with the risk of PD with cognitive impairment, and 5 factors were associated with specific cognition domains. Conclusions: Effective interventions in the management of PD symptoms, comorbidities, and lifestyles may be promising to reduce PD with cognitive impairment risk.

show abstract

“…Brady (2017) put tipping point within the context of palliative and end‐of‐life care for persons with end‐stage renal disease. Cognitive dysfunction in Parkinson's disease was described as a tipping point for nursing home placement or major caregiver stress . A fitness‐frailty measure was described that represented the tipping point between functional independence and reliance on others …”

Section: Resultsmentioning

confidence: 99%

“…A tipping point represents a point of dramatic change in the caregiving situation as indicated by expressions such as “critical juncture,” “huge and personal decision,” and “everything can change.” Examples are Brady's (2017) use of tipping point in the context of initiating end‐of‐life care and Safarpour and Willis's use of tipping point in the context of nursing home placements.…”

Section: Resultsmentioning

confidence: 99%

“…33 Patient teaching guidelines for preventing the point that results in a "metabolic meltdown" were discussed in the context of Type 2 diabetes, 63 scribed as a tipping point for nursing home placement or major caregiver stress. 64 A fitness-frailty measure was described that represented the tipping point between functional independence and reliance on others. 65 We also explored colloquial definitions or ways the concept of tipping point is used in conventional conversations, popular literature, or the media.…”

Section: Definitionsmentioning

confidence: 99%

See 1 more Smart Citation

“Tipping point” concept analysis in the family caregiving context

et al. 2019

View full text Add to dashboard Cite

Aim Analyze the concept “tipping point” in the older adult family caregiving context to further knowledge about caregiving families, enhancing transdisciplinary theory, research, and practice. Background While used commonly in some disciplines, how “tipping point” has been used in health care, generally, and in relation to caregiving families, specifically, is less clear. This project was conducted to offer conceptual clarity to tipping point. Design Walker and Avant's framework. Data Source Searches of scholarly literature in PsycINFO, CINAHL, and PubMed using the search term “tipping point” in either title or abstract. Review Methods Definitions used were extracted; instances when the concept was implied but the actual term “tipping point” was not used and contexts where the term was used or implied were identified. Results The composite definition of a caregiving tipping point is a seemingly abrupt, severe, and absolute change event involving either the older adult or caregiver(s), or both that indicates a breakdown in the status quo of the caregiving system. Conclusions Transdisciplinary research, care, and policy should treat caregiving families as complex systems, use longitudinal assessments, and include colloquial communication. Early detection of impending tipping points will provide family‐centered decisional support and enhance families’ quality of life and safety.

show abstract

Clinical Epidemiology, Evaluation, and Management of Dementia in Parkinson Disease

Cited by 17 publications

References 89 publications

Effect of rTMS on Parkinson's Cognitive Function: A Systematic Review and Meta-analysis

Effect of rTMS on Parkinson's Cognitive Function: A Systematic Review and Meta-analysis

Modifiable risk factors for cognitive impairment in Parkinson's disease: A systematic review and meta‐analysis of prospective cohort studies

“Tipping point” concept analysis in the family caregiving context

Contact Info

Product

Resources

About