Objective: To identify neurocognitive domain and mild cognitive impairment (MCI) subtype associated with conversion from non-demented patients with Parkinson’s disease (PD) and PD-MCI to dementia with Parkinson’s disease (PDD).

Background: Dementia is a key symptom of PD, and influences the patient’s quality of life and the caregiver’s burden. However, the most predictable neurocognitive domain for development of PDD is still disputed.

Methods: Non-demented PD patients who had undergone comprehensive neuropsychological tests at baseline assessment were included in this study. We compared the data between individuals who converted to PDD from the whole, as well as from those with PD-MCI, with that of non-converters, and analyzed risk factors for PDD.

Results: In total, 390 patients with PD were included, and 47 patients had converted to PDD over a mean follow-up period of 6.4 years. Old age and the presence of MCI were the most significant clinical risk factors for conversion to PDD. In neurocognitive domains, converters showed poor performance in language, visuospatial, and memory domains than non-converters. At baseline assessment, 161 patients had been diagnosed with PD-MCI. PD-MCI patients showed older, older at disease onset, higher Hoehn and Yahr stage, and lower Mini-Mental State Examination score and education level than cognitively intact patients with PD. Among the PD-MCI patients, 30 had converted to PDD. Patients with multi-domain MCI converted to PDD more often than patients with single-domain MCI. Converters showed more visuospatial dysfunction than non-converters in PD-MCI patients.

Conclusions: Dysfunctions in the language, visuospatial, and memory domains were associated with conversion from non-demented PD to PDD in the total. In PD-MCI patients, visuospatial dysfunction was the only neurocognitive domain related to conversion to PDD. Therefore, neurocognitive domains of posterior cortex might be relevant to conversion to dementia in PD patients.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuro-cognitive-domain-related-to-conversion-of-parkinsons-disease-dementia/