The Frequency and Associated Risk Factors for Dementia in Patients With Parkinson's Disease

Marder, Karen; Tang, Mingxin; Côté, Lucien J.; Stern, Yaakov; Mayeux, Richard

doi:10.1001/archneur.1995.00540310069018

Cited by 237 publications

(173 citation statements)

References 26 publications

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“…Although age, time of disease and even a greater age at the start of the PD have been indicated in the literature as risk factors for the occurrence of cognitive impairment 2,4 , in agreement with other authors 17,18 , no such relationship was found in the present study.…”

Section: Clinical Aspects and Cognitive Declinesupporting

confidence: 92%

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Dementia and mild cognitive impairment in patients with Parkinson's disease

Fonseca¹,

Letro²,

Bossoni³

et al. 2009

Arq. Neuro-Psiquiatr.

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-The objective of this research was to assess the occurrence of cognitive impairment in 32 individuals (average age: 67.2 years old) with Parkinson's disease (PD). Procedures: clinical-neurological assessment; modified Hoehn and Yahr staging scale (HYS); standard neuropsychological battery of CERAD (Consortium to Establish a Registry for Alzheimer's Disease); Pfeffer questionnaire; and Clinical Dementia Rating. A comparison was made with a control group (CG), consisting of 26 individuals with similar age and educational level but without cognitive impairment. The PD patients showed an inferior performance in the CERAD battery when compared to the CG. Three PD sub-groups were characterised according to cognition: no cognitive impairment -15 cases; mild cognitive impairment -10; dementia -7 cases. There was a significant association between motor disability (HYS) and the occurrence of dementia. Dementia and mild cognitive impairment frequently occur in PD patients and should be investigated in a routine way.KEY woRDS: Parkinson disease, dementia, cognition. Demência e transtorno cognitivo leve em pacientes com doença de ParkinsonResumo -o objetivo desta pesquisa foi avaliar a ocorrência de déficits cognitivos em 32 indivíduos (idade média: 67,2 anos) com doença de Parkinson (DP). Procedimentos: avaliação clínico-neurológica, escala de Hoehn and Yahr modificada (EHY), bateria neurospicológica do CERAD (Consortium to Establish a Registry for Alzheimer's Disease), questionário de Pfeffer e escore clínico da demência (Clinical Dementia Rating). Foi feita comparação com grupo controle (GC) de 26 indivíduos sem declínio cognitivo, com idade e nível educacional similares. os pacientes com DP tiveram desempenho inferior na bateria CERAD, quando comparados ao do GC. Foram caracterizados 3 subgrupos com PD segundo a cognição: sem déficits cognitivos -15 casos; transtorno cognitivo leve -10; demência -7 casos. Houve associação entre comprometimento motor e ocorrência de demência. Demência e transtorno cognitivo leve são freqüentes em pacientes com DP e devem ser investigados de modo rotineiro.PAlAvRAS-CHAvE: doença de Parkinson, cognição, demência.

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Section: Clinical Aspects and Cognitive Declinesupporting

confidence: 92%

“…The finding of 21.8% dementia in the cases assessed in this study is in agreement with the values from 17.68% to 41.3% reported in community studies that used the criteria of the Diagnostic and Statistical Manual of Mental Disorders (DSM)-IIIR to characterise dementia 16,17,27,28 .…”

Section: Dementia and Mild Cognitive Impairment In Pdsupporting

confidence: 91%

Dementia and mild cognitive impairment in patients with Parkinson's disease

Fonseca¹,

Letro²,

Bossoni³

et al. 2009

Arq. Neuro-Psiquiatr.

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“…However, even in early stages there is a marked clinical heterogeneity, which is in part attributable to the occurrence of cognitive impairments (Foltynie et al, 2002;Lewis et al, 2005). In general, the incidence of dementia among PD patients is two to three times higher than in age-matched controls (Marder et al, 1995;Aarsland et al, 2003). Approximately 30 -50% of the PD patients develop dementia during a 4 -8 year follow-up period (Aarsland et al, 2003;Williams-Gray et al, 2007), and the risk of developing dementia increases as the disease progresses (Braak et al, 2005).…”

Section: Introductionmentioning

confidence: 99%

Functional Convergence of Dopaminergic and Cholinergic Input Is Critical for Hippocampus-Dependent Working Memory

Wisman¹,

Şahin²,

Maingay³

et al. 2008

J. Neurosci.

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Although Parkinson's disease is a movement disorder, in many patients cognitive dysfunction is an important clinical sign. It is not yet clear whether this is attributable solely to a decrease in dopamine levels, or whether other neurotransmitter systems might be involved as well. In the present study, the importance of the mesocorticolimbic dopamine pathway and a possible convergence with forebrain cholinergic projections to neocortex and hippocampus in the regulation of learning and memory abilities were investigated by using specific lesion paradigms in one or both systems. Lesioning of dopaminergic neurons in the ventral tegmental area resulted in an impaired performance in the reference memory task, whereas the execution of the working memory tasks appeared to be unaffected in the Morris water maze. Analysis of the swim paths revealed that the dopamine-depleted animals were capable of adapting a search strategy on a given testing day but failed to transfer this information to the next day, suggesting a deficit in information storage and/or recall. In contrast, cholinergic lesions alone were without effect in all test paradigms. However, when both dopamine and acetylcholine were depleted, animals were also impaired in the working memory task, indicating that a functional convergence of the inputs from these systems was critical for acquisition of spatial memory. Interestingly, such an additional acquisition deficit appeared only after hippocampal cholinergic depletion regardless of a concurrent disruption of basalocortical cholinergic afferents. Thus, further analyses of cholinergic alterations may prove useful in better understanding the cognitive symptoms in Parkinson's disease.

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“…[3][4][5][6] Extension of the neurodegenerative process beyond the brain stem is probably the basis for some of the clinical features, including nonmotor deficits such as dementia. Although dementia frequently occurs in the late stages of PD and is associated with increasing disability, mainly in elderly cohorts, 7,8 its neuroanatomic basis is still controversial. In particular, it is unclear whether cognitive deterioration is primarily a cortical or a subcortical process.…”

mentioning

confidence: 99%