Movement Disorders with Dementia in Older Adults

Abstract

Dementias associated with movement disorders are the second most common form of dementia in old age after Alzheimer's disease. This chapter outlines the key neurological, neuropathological, neuroimaging, and neuropsychological features of two synucleinopathies (Parkinson's disease dementia and dementia with Lewy bodies) and two tauopathies (corticobasal syndrome and progressive supranuclear palsy). Neuropsychological evaluation of patients with movement disorders can be challenging, and some common pitfalls and suggestions for avoiding them are presented. Particular attention is paid to the type of information that must be elicited from medical records and the interview to plan an effective evaluation. Recommended instruments for the assessment and screening of cognition and psychiatric conditions, such as apathy and depression, are identifi ed and some compensatory techniques are described. A case study is presented to illustrate the application of such instruments in the clinical setting.

Information processing deficit in older adults with HIV infection: A comparison with Parkinson’s disease.

“…Research on IP speed has primarily assessed psychomotor speed through tasks, which include a motor component. We used the oral version of the SDMT to eliminate hand and arm motor involvement, consistent with guidelines for cognitive assessment in PD (Marras et al, 2014; Tröster & Browner, 2013). IP speed in our sample of older HIV–infected participants was impaired relative to older C and individuals with PD.…”

“…This article is intended solely for the personal use of the individual user and is not to be disseminated broadly. (Marras et al, 2014;Tröster & Browner, 2013) This article is intended solely for the personal use of the individual user and is not to be disseminated broadly.…”

“…In patients with PD, IP speed has been identified as primary frontostriatal cognitive correlate, which may contribute to impairments in other cognitive domains (Price et al, 2016). To test cognitive ability with minimal demands on motor function in PD, it has been recommended that tasks measuring IP speed be administered orally (Marras, Tröster, Kulisevsky, & Stebbins, 2014;Tröster & Browner, 2013). The oral version of the Symbol Digit Modalities Test (SDMT) can be used to accurately assess IP speed in such populations (Sheridan et al, 2006;Smith, 1968Smith, , 1982.…”

The tools of the trade: A state of the art “How to Assess Cognition” in the patient with Parkinson's disease

“…Tr€ oster and Browner have outlined some possible considerations and modifications in standard test administration procedures in persons with movement disorders. 36 Downward gaze palsy in atypical parkinsonism may require that stimuli are held up for the patient to see at eye level, about 18 00 from the patient's face. Patients with marked dysarthria may need to be tested over multiple, brief sessions if they are asked to repeat responses.…”