Parkinson disease and cognitive impairment

Abstract

Purpose of review: While the distinctive motor symptoms of Parkinson disease (PD) have been described for centuries, cognitive impairment has only recently been recognized as a central feature. Studies have yielded clues to the etiology and natural history of cognitive impairment in PD, but much remains unclear and effective therapies are needed. Recent findings: Longitudinal cohort studies demonstrate that almost all patients with PD will develop dementia if they live long enough. New CSF biomarker and genetic studies suggest that it may soon be possible to forecast and track the progression of dementia in PD. Sleep and sleep disturbance appear to be intrinsically linked with PD, although the implications for individual outcomes and opportunities for intervention are unclear. Multidisciplinary treatment approaches incorporating cognitive training may help to improve outcomes. Summary: We review several recent advances in understanding the pathophysiology, genetics, and management of cognitive impairment in PD. Neurol Clin Pract 2016;6:452-458 C ognitive impairment is a disabling comorbidity for many patients with Parkinson disease (PD) and represents a major challenge for physicians, caregivers, and the health care system.Prevalence and natural history of PD dementia: Near-universal prevalence and progression Clinical features of cognitive impairment in PD involve a wide range of cognitive domains, including executive function, visuospatial reasoning, memory, and language function, and can include additional features including visual hallucinations, paranoia, and fluctuations in attention.1 PD is often marked primarily by visuospatial and executive deficits, in contrast to Alzheimer disease (AD), where memory impairment predominates. Cognitive impairment in PD encompasses a spectrum of severity from relatively mild symptoms to end-stage

Clinical Spectrum, Risk Factors, and Behavioral Abnormalities among Dementia Subtypes in a North Indian Population: A Hospital-Based Study

“…There is a scarcity of studies involving MD in developing countries, which highlights the urgent need for its identification and management. Dementia in Parkinson disease has recently gained recognition [ 50 ]. PRD comprising of PDD and DLB has usually been associated with cognitive impairment.…”

Genetically engineered animal models of Parkinson's disease: From worm to rodent

“…Patients often display neuropsychiatric problems (such as depression, anxiety and/or cognitive impairment), sleep disorders (insomnia, restless‐leg syndrome, REM sleep disturbances), olfactory and autonomic dysfunctions (bladder and sexual dysfunctions, constipation, cardiac dysautonomia, etc.) and have been recently reviewed by others in more detail (Chaudhuri, Odin, Antonini & Martinez‐Martin, ; Davis & Racette, ; Lima, Martins, Delattre, Proenca & Mori, ; Schapira, Chaudhuri & Jenner, ). Non‐motor symptoms have a significant impact on the quality of life of patients.…”

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

“…Deterioration in cognition can affect many domains, such as memory, attention, language, learning, visuospatial abilities, and executive function. The prevalence of PDD is nearly 25% to 30% of total PD cases and elevates drastically with advanced age . It was reported by the Sydney Multicenter Study, with the longest follow‐up to date, that 83% of PD patients who survived 20 years developed dementia .…”