Dementia in Parkinson's disease: a post‐mortem study in a population of brain donors

Papapetropoulos, Spiridon; Gonzalez, Jeffrey S.; Lieberman, Arnold L.; Mash, Deborah C.

doi:10.1002/gps.1297

Cited by 35 publications

(19 citation statements)

References 36 publications

(36 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Our figure (62%) for depression is similar to that found in the Sydney studies [4,5], but higher than the 43% reported by Papapetropoulos et al [2], in a retrospective study. Possibly, the prominent dysarthria, cognitive impairment, severe hypomimia and apathy might have biased this figure [24].…”

Section: Levodopa-induced Motor Complicationssupporting

confidence: 89%

“…Information on clinical features of LS-PD is relatively sparse [1,2,4,5,8,16]. Papapetropoulos and Mash [16] have reported on the frequency of motor complications in a cohort of 61 patients with LS-PD, although only two-thirds of their patients were H&Y greater than three.…”

Section: Discussionmentioning

confidence: 96%

“…In the pre-levodopa era, reporting on the clinical features of 100 parkinsonian patients, Martin et al [1] found that patients in later Hoehn and Yahr (H&Y) stages had frequent and severe cognitive decline besides severe motor impairment. In recent times, after the introduction of therapies such as levodopa or deep brain stimulation, cross-sectional studies have shown worsening of sleep problems, dysautonomia and cognition with advancing disease [2,3]. The longitudinal studies by Hely et al [4,5], describe patients in late-stage PD with common but not disabling dyskinesias and on-off fluctuations, with dementia and dependency on carers eventually occurring in most, whose major disability relates to motor and non-motor symptoms not improved by levodopa.…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Late-stage Parkinson’s disease: the Barcelona and Lisbon cohort

et al. 2010

View full text Add to dashboard Cite

Studies of late stages of Parkinson's disease (LS-PD) are limited. To provide an adequate health plan for patients in these most advanced stages, accurate information on their clinical condition is necessary. We characterize clinical features and medication use of LS-PD. A cross-sectional study of LS-PD stage 4 or 5 of Hoehn and Yahr during on states is presented in this paper. Demographics, clinical features and medication data were obtained using a structured questionnaire and physical examination. Patients were asked to grade the perceived impact of symptoms on their health status. Fifty patients (mean age 74.1 years and mean disease duration 17.9 years) were studied. Severe akinetic symmetric parkinsonism was present in most, with negligible rigidity and tremor, and most patients were wheelchair-bound. Severe postural instability and freezing of gait, causing frequent falls and fractures, and prominent dysarthria and dysphagia dominated the motor syndrome. Levodopa remained effective in most patients in relieving motor symptoms including tremor. Motor fluctuations and dyskinesias were present in 78 and 62% of patients, respectively, but were not perceived as disabling. All had neuropsychiatric and dysautonomic symptoms. Visual hallucinations were present in 44%, depression in 62% and dementia in 50%. Lack of tremor (p < 0.01) and absence of depression (p < 0.01) were independently associated with dementia (R(2) = 45%). Symptoms causing greatest impact on perceived health status were falls, gait unsteadiness, urinary dysfunction and sweats. Motor and non-motor non-levodopa responsive problems were frequent and the main cause of disability. Fluctuations and dyskinesias were frequent though not disabling. Dementia is not unavoidable in these very late stages.

show abstract

Section: Levodopa-induced Motor Complicationssupporting

confidence: 89%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Late-stage Parkinson’s disease: the Barcelona and Lisbon cohort

et al. 2010

View full text Add to dashboard Cite

show abstract

“…Although the cardinal motor symptoms predominate in the initial stage, many patients with PD develop impairment of their cognitive functions that is sufficient to fulfill the diagnosis of dementia [2]. PD dementia (PDD) is characterized by cognitive dysfunction of the executive function and the attention, visuospatial and constructional abilities [3].…”

Section: Introductionmentioning

confidence: 99%

Cognitive Dysfunctions in Mild Parkinson’s Disease Dementia: Comparison with Patients Having Mild Alzheimer’s Disease and Normal Controls

et al. 2007

View full text Add to dashboard Cite

Objective: Although the neuropsychological differences between Alzheimer’s disease (AD) and Parkinson’s disease dementia (PDD) have been scrutinized in several studies, no study to date has directly compared the cognitive impairment profiles of patients with mild PDD and those with mild AD. In this study, we investigated the cognitive changes of mild PDD patients as compared with age- and education-matched normal controls and matched mild AD patients. Methods: Thirty-one patients with PDD, 24 patients with probable AD (pAD), and 50 controls were recruited prospectively. All the subjects were evaluated with a battery of detailed neuropsychological tests for the assessment of attention, memory, language, and the visuospatial and frontal executive functions. Results: The PDD and pAD groups demonstrated significant impairments in all cognitive domains compared with the control group. These cognitive declines attributable to dementia were similar in the PDD and pAD patients, but they were not identical. In the subdomain analysis, the pAD group demonstrated more marked changes in delayed memory performance than did the PDD group. Conclusions: Our result showed that the cognitive changes in mild PDD patients did not differ from those in the mild pAD patients, except for delayed memory items. We concluded that it is difficult to sharply distinguish between mild PDD and mild AD.

show abstract

“…Factors that may account for the differences in the frequency of visual hallucinations between PSP and PD patients (our previously reported frequency of hallucinations in PD patients of our Brain Bank cohort is 52.2% [13] ) are: (a) regional neurochemical differences in cholinergic and monoaminergic degeneration; (b) the decreased survival of PSP versus PD patients and (c) the early discontinuation of dopaminergic treatment due to loss of effi cacy. Our report has certain limitations commonly seen in retrospective studies.…”

mentioning

confidence: 99%