Dementia and Cognitive Impairment in Patients With Parkinson’s Disease From India

Abstract

Depression and cognitive impairment are frequent manifestations in Parkinson's disease (PD). Although a few longitudinal studies have reported on depression and dementia in PD, there is a yet a lack of such studies in India. This 7-year longitudinal study is a hospital-based prospective case (n = 250)-control (n = 280) study. In all, 36.8% had PD with no cognitive impairment (PD-Normal), 27.2% of the patients with PD were affected by dementia (PDD), and 36% of the remaining patients with PD had mild cognitive impairment (PD-MCI) at baseline. After 7 years of evaluation, 32 new patients, 12 patients from the PD-MCI group and 9 patients from the PD-Normal group, were diagnosed with dementia. The 7-year prevalence rate for dementia was estimated to be 49.28%. In the Indian population, an early onset of dementia is noted among patients with PD, with the age of onset being less than 55 years. Patients with early-onset PDD showed depression symptoms that differed significantly from the controls of the same age-group. There was a major difference in verbal fluency, word list recall, constructional praxis and recall, word list recognition, abridged Boston Naming Test, word list memory with repetition, and Mini-Mental State Examination between PD-MCI and PDD groups. Hallucinations before baseline (odds ratio [OR] = 4.427, 95% confidence interval [CI] = 2.122-9.373), akinetic/tremor dominancy (OR = 0.380, 95%CI = 0.149-0.953), and asymmetrical disease onset (OR = 0.3285, 95%CI = 0.1576-0.685) can be considered as risk factors for patients with dementia. Patients with early-onset PD might be more prone to complex depression and dementia. As the disease progresses, akinetic-dominant PD, early hallucinations, and asymmetrical disease onset are the potential risk factors for the development of dementia in patients with PD.

Dementia and co‐occurring chronic conditions: a systematic literature review to identify what is known and where are the gaps in the evidence?

“…The second new outcome was disease-specific; namely that living with dementia and diabetes increased the risk for severe hypoglycemia compared with persons living with diabetes and without dementia (Abbatecola et al , 2015; Prinz et al , 2015). Fourteen new articles (Chang et al , 2012; Chen et al , 2014; Huijts et al , 2013; Llibre et al , 2014; Katsoulis et al , 2014; Lee et al , 2015; Mignardot et al , 2014; Murao et al , 2014; O’Donnell et al , 2012; Park et al , 2016; Sanyal et al , 2014; Warchol-Celinska et al , 2015; van Asch et al , 2013) fell into existing chronic condition-outcome pairings and did not change the quality or strength of the evidence, and four articles (Hawkins et al , 2012; Jacobs et al , 2012; Hajduk et al , 2013; Provencher et al , 2015) were found in separate areas where there was previously no evidence.…”

Prevalence and treatment pattern ofParkinson's disease dementia inKorea

“…The point prevalence of dementia in PD was similar to previous epidemiological studies; one recent systematic review including 13 studies found that 31.3% of PD patients had dementia . Another study in India showed that 27.2% of PD patients had dementia and 36.8% of patients had MCI at baseline . In Italy, MCI was found in approximately 53% of 290 PD patients .…”

Quantitative EEG (QEEG) Measures Differentiate Parkinson's Disease (PD) Patients from Healthy Controls (HC)

“…The progression rate from PD-MCI to PD dementia (PD-D) varies depending on age, disease duration and other factors, but one study found it to be approximately 60% over 4 years (Janvin et al, 2006). Other studies found it to be 45–60% while following up for 4–12 years (Buter et al, 2008) and a 49.28% prevalence rate for dementia over 7 years (Sanyal et al, 2014). …”