Session Information
Date: Wednesday, June 22, 2016
Session Title: Parkinson's disease: Cognition
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To evaluate and describe characteristics of Parkinson’s disease (PD) patients who develop dementia during follow-up in a longitudinal study.
Background: Important non-motor features of PD are cognitive decline and dementia. Except for age and severity of PD symptoms being associated with cognitive symptom progression, course and severity of cognitive decline is variable and rather unpredictable.
Methods: A longitudinal cohort of 246 incident PD patients from a population-based study, was followed for 5 years to on average 7.5 years of PD duration. We assessed differences in PD symptom progression and lifestyle factors in patients who developed dementia after baseline (MMSE≤24) versus those who did not, using t-tests, chi-square tests, and Cox proportional hazards regression. We conducted repeated measurement analyses of progression using the UPDRS, GDS, and lifestyle data.
Results: Overall, 34 patients developed dementia during follow-up. At baseline these patients were slightly older, more often of non-European ancestry, and took more levodopa (mean 376.2 mg/day (SD 245.9) vs 267.6 (SD 267.6)). Though their scores were similar at baseline, across follow-up, progression of depressive (GDS) and motor symptoms (UPDRS-III) mirrored cognitive decline: those who developed dementia experienced a mean change in GDS of 2.8 (SD 3.6) points compared with 0.69 (SD 3.0) points in non-demented patients, and 22.1 (SD 17.8) points on the UPDRS-III vs 9.4 (SD 11.6) points. The postural instability gait difficulty (PIGD) subtype was more common in those who developed dementia and in time to dementia analysis, the tremor dominant (TD) subtype was protective against dementia (Hazard Ratio HR=0.22, 95% CI=0.05-0.94, p=0.04); the TD subtype was also protective in time to all-cause mortality (HR=0.66, 95% CI=0.43, 1.00, p=0.05).
Conclusions: Our data support previous research that indicated correlations between motor and non-motor symptom severity such that decline is experienced in multiple domains simultaneously.
To cite this abstract in AMA style:
A. Keener, K. Paul, A. Folle, J. Bronstein, B. Ritz. Predictors of dementia in Parkinson’s disease: A population-based cohort study [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/predictors-of-dementia-in-parkinsons-disease-a-population-based-cohort-study/. Accessed December 10, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/predictors-of-dementia-in-parkinsons-disease-a-population-based-cohort-study/