Evolution of cognitive dysfunction in an incident Parkinson's disease cohort
C H Williams-Gray1, T Foltynie, C E G Brayne
1Cambridge Centre for Brain Repair, Department of Clinical Neurosciences, University of Cambridge, Forvie Site, Robinson Way, Cambridge, CB2 2PY, UK. chm27@cam.ac.uk
Brain : a Journal of Neurology
|May 31, 2007
Summary
Cognitive decline in Parkinson's disease (PD) is common early on. Predictors include gait issues and specific cognitive tests, suggesting non-dopaminergic pathology and aiding prognosis.
Area of Science:
- Neurology
- Neuropsychology
- Geriatrics
Background:
- Cognitive dysfunction is prevalent in early idiopathic Parkinson's disease (PD).
- Understanding the evolution of cognitive impairment is crucial for prognosis.
Purpose of the Study:
- To examine the longitudinal progression of cognitive dysfunction in early Parkinson's disease.
- To identify early clinical predictors of cognitive decline and dementia in PD.
Main Methods:
- Longitudinal follow-up of 126 patients with idiopathic PD (3-5 years post-diagnosis).
- Re-validated PD diagnoses using UKPDS Brain Bank criteria.
- Assessed cognitive function, including dementia, frontostriatal deficits, and posterior cortical tasks.
Main Results:
- 10% of PD patients developed dementia within 3.5 years.
- 57% showed cognitive impairment, primarily frontostriatal deficits.
- Posterior cortical deficits (semantic fluency, pentagon copying) and non-tremor dominant phenotype predicted cognitive decline.
Conclusions:
- Cognitive decline in early PD is characterized by frontostriatal and posterior cortical deficits.
- Gait dysfunction and posterior cortical deficits predict dementia, suggesting Lewy body pathology.
- Early identification of predictors can guide prognosis in clinical settings.
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