Cognitive impairment in Parkinson’s disease: a report from a multidisciplinary symposium on unmet needs and future directions to maintain cognitive health

Abstract

People with Parkinson’s disease (PD) and their care partners frequently report cognitive decline as one of their greatest concerns. Mild cognitive impairment affects approximately 20–50% of people with PD, and longitudinal studies reveal dementia in up to 80% of PD. Through the Parkinson’s Disease Foundation Community Choice Research Award Program, the PD community identified maintaining cognitive function as one of their major unmet needs. In response, a working group of experts across multiple disciplines was organized to evaluate the unmet needs, current challenges, and future opportunities related to cognitive impairment in PD. Specific conference goals included defining the current state in the field and gaps regarding cognitive issues in PD from patient, care partner, and healthcare professional viewpoints; discussing non-pharmacological interventions to help maintain cognitive function; forming recommendations for what people with PD can do at all disease stages to maintain cognitive health; and proposing ideas for how healthcare professionals can approach cognitive changes in PD. This paper summarizes the discussions of the conference, first by addressing what is currently known about cognitive dysfunction in PD and discussing several non-pharmacological interventions that are often suggested to people with PD. Second, based on the conference discussions, we provide considerations for people with PD for maintaining cognitive health and for healthcare professionals and care partners when working with people with PD experiencing cognitive impairment. Furthermore, we highlight key issues and knowledge gaps that need to be addressed in order to advance research in cognition in PD and improve clinical care.

Ethnic Variation in the Manifestation of Parkinson’s Disease: A Narrative Review

“…Cognitive impairment is one of the most frequent and disabling non-motor symptoms of PD [117]. The typical cognitive domains affected by PD dementia are visuospatial, executive and attention, but there can be global deficits, particularly in advanced disease.…”

Long-Term Treatment with Fluvoxamine Decreases Nonmotor Symptoms and Dopamine Depletion in a Postnatal Stress Rat Model of Parkinson’s Disease

“…Besides, stress has been shown to have a major impact on neurodegeneration affecting behavioral symptoms in brain disorders such as Parkinson's disease (PD) [3,4]. There is considerable evidence to show that most individuals with PD also display anxiety, depression, or cognitive deficits many years before their diagnosis of PD [5][6][7][8][9]. It is well known that exposure to stress during early life can have long-term detrimental effects on brain development [1].…”

Longitudinal brain atrophy distribution in advanced Parkinson's disease: What makes the difference in “cognitive status” converters?

“…While there are excellent therapeutic concepts for nowadays well‐manageable motor symptoms (Chaudhuri, Odin, Antonini, & Martinez‐Martin, ), one of the major challenges in advanced Parkinson's disease (PD) is decreasing cognitive functioning since up to 80–83% of PD patients develop dementia (Goldman et al, ; Hely, Reid, Adena, Halliday, & Morris, ). Impaired cognition negatively impacts functioning, quality of life, caregiver burden, and health‐related costs; therapeutic options are still limited and have been highlighted as a major target for future clinical trials (Aarsland et al, ).…”