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

Abstract

-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.

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

“…29 The memory difficulties expressed in their recall deficit of the word list in this study could reflect the involvement of multiple cortical and subcortical neural pathways and not temporal-limbic involvement 4 caused by a slowing up of the information process or by impairment of evocative strategies more than a mnemic deficit as such. These mechanisms also contribute to the difficulties shown in the word list memory with repetition task, and this finding is similar to that of Tedrus et al 26 The major methodological limitation of our study was the extended period of assessments, and thus a degree of attrition in this group of elderly individuals was anticipated. Dementia might reduce the survival in patients with PD, and in some cases, patients developed dementia between the last evaluation and death, indicating that the prevalence observed is a conservative estimate.…”

“…A strong association was found between the early occurrence of dementia and greater gravity of motor compromise in patients with PD compared to controls ( Table 1, panel C), as assessed by the H&Y stages, and this finding is similar to the studies previously reported from the Brazilian population. 26 Thus, compared to cognitively preserved individuals, the MMSE ratings differed significantly among patients who had PD much early in their life, thereby dementia setting in among individuals having PD for a longer duration. These individuals were found to have a more advanced clinical stage of dementia and had greater functional impairment.…”

Coherence of brain electrical activity: a quality of life indicator in Alzheimer’s disease?Coerência da atividade elétrica cerebral: indicador da qualidade de vida na doença de Alzheimer?

“…The clinical manifestations of Parkinson's disease (PD) are essentially motor, but cognitive and behavioral disturbances also occur, characterizing dementia in approximately 30% of the cases 1,2 . Today the most common and well-known definition of QOL is that of the World Health Organization (WHO), which defines it as an individual' s perception of his position in life in the context of the culture and value systems in which he lives and in relation to his goals, expectations, standards, and concerns 3 .…”

Mild Cognitive Impairment in Parkinson’s Disease: A Review of Current Concepts

“…PD-MCI is associated with increasing age [19, 20, 22], male gender [20], and lower levels of education [23]. In addition, PD-MCI is generally associated with later onset of disease [20, 22], greater PD severity [19, 20, 22], and longer disease duration [3, 22].…”

“…Whilst the majority of studies have reported that nontremor features of bradykinesia, rigidity, postural instability, and gait disorder are particularly associated with cognitive dysfunction [22, 24, 25], some authors have reported that patients with tremor-dominant features are more cognitively impaired [23] and others have failed to identify any difference in motor phenotype [26]. It should be highlighted that these studies did not specifically explore the issue of PD-MCI but focused on the cognitive impairments associated with motor phenotype, although Verbaan et al (2007) gave specific consideration to the stratification of patients by their age of onset (≤50 and >50) and disease duration (≤10 years and >10 years) [22].…”