Identifying comorbidities and lifestyle factors contributing to the cognitive profile of early Parkinson’s disease

Abstract

Background Identifying modifiable risk factors for cognitive impairment in the early stages of Parkinson’s disease (PD) and estimating their impact on cognitive status may help prevent dementia (PDD) and the design of cognitive trials. Methods Using a standard approach for the assessment of global cognition in PD and controlling for the effects of age, education and disease duration, we explored the associations between cognitive status, comorbidities, metabolic variables and lifestyle variables in 533 PD participants from the COPPADIS study. Results Among the overall sample, 21% of participants were classified as PD-MCI (n = 114) and 4% as PDD (n = 26). The prevalence of hypertension, diabetes and dyslipidemia was significantly higher in cognitively impaired patients while no between-group differences were found for smoking, alcohol intake or use of supplementary vitamins. Better cognitive scores were significantly associated with regular physical exercise (p < 0.05) and cognitive stimulation (< 0.01). Cognitive performance was negatively associated with interleukin 2 (Il2) (p < 0.05), Il6 (p < 0.05), iron (p < 0.05), and homocysteine (p < 0.005) levels, and positively associated with vitamin B12 levels (p < 0.005). Conclusions We extend previous findings regarding the positive and negative influence of various comorbidities and lifestyle factors on cognitive status in early PD patients, and reinforce the need to identify and treat potentially modifiable variables with the intention of exploring the possible improvement of the global cognitive status of patients with PD.

Sex Differences in Motor and Non-Motor Symptoms among Spanish Patients with Parkinson’s Disease

“…Very severe NMS burden was defined as a NMSS total score >70 [ 20 ]. Patient with a score <81 on the PD-CRS were considered as with cognitive impairment [ 25 , 26 ]. Patients were classified as with major depression according to the DSM-IV criteria [ 27 , 28 ].…”

Trajectories of health conditions and their associations with the risk of cognitive impairment among older adults: insights from a national prospective cohort study

“…We found that high multimorbidity status was a risk factor for cognitive impairment. Cross-sectional studies reported that multimorbidity was correlated with cognitive impairment [ 32 , 33 ]. Limited studies have explored the association between comorbidity at multiple time points and cognitive impairment among older adults.…”

Cognitive Function, and Its Relationships with Comorbidities, Physical Activity, and Muscular Strength in Korean Older Adults

“…In agreement with the current findings, previous studies reported inverse associations between comorbidities and cognitive function in community-dwelling older Korean adults [ 24 ], elderly Indian residents [ 25 ], and community-dwelling older Irish adults [ 26 ]. Furthermore, the negative impact of comorbidities on cognitive function has been observed in Canadian patients with dementia, mild cognitive impairment, and normal cognition [ 27 ]; European patients with type-2 diabetes [ 28 ]; Chinese patients with first-ever ischemic stroke [ 29 ]; Spanish patients with Parkinson’s disease [ 30 ]; and older Chinese patients with dementia [ 31 ]. Together, the findings from the present study and earlier ones concur that comorbid conditions have an adverse effect on cognitive function among older adults.…”