Mild cognitive impairment in Parkinson's disease versus Alzheimer's disease
Lilah M Besser1, Irene Litvan2, Sarah E Monsell1
1National Alzheimer's Coordinating Center, University of Washington, 4311 11th Ave NE, Suite 300, Seattle, WA, 98105, USA.
Introduction:
No known studies have compared longitudinal characteristics between individuals with incident mild cognitive impairment due to Parkinson's disease (PD-MCI) versus Alzheimer's Disease (AD-MCI).
Methods:
We used longitudinal data from the National Alzheimer's Coordinating Center's Uniform Data Set to compare 41 PD-MCI and 191 AD-MCI participants according to their demographics, presence of ≥1 APOE e4 allele, and baseline and change over time in clinical characteristics, neuropsychological test scores, and Clinical Dementia Rating sum of boxes (CDR-SB). Multivariable linear regression models with generalized estimating equations were used to account for clustered data and to test for baseline and longitudinal differences in neuropsychological test scores.
Results:
PD-MCI and AD-MCI participants differed by many demographic and clinical characteristics. Significantly fewer PD-MCI participants developed dementia over one year. Compared to AD-MCI participants, PD-MCI participants performed better at baseline and over time on a global measure of cognition (Mini Mental State Exam), memory measures (immediate and delayed Logical Memory), and a language measure (Boston Naming Test), and additionally performed better over time on an attention measure (Digit Span Forward), a language measure (Vegetable List), a processing speed measure (Digit Symbol), and an overall measure of memory and functional impairment (CDR-SB).
Conclusion:
Our study provides further evidence that PD-MCI is clinically distinct from AD-MCI and requires different tools for diagnosis and monitoring clinical progression. More importantly, this study suggests that PD-MCI takes longer to convert into dementia than AD-MCI, findings that require replication by other studies.
Insights
This study found that mild cognitive impairment due to Parkinson's disease (PD-MCI) is distinct from Alzheimer's Disease MCI (AD-MCI), with PD-MCI patients progressing more slowly to dementia.
Area of Science:
- Neurology
- Neuroscience
- Gerontology
Background:
- Mild cognitive impairment (MCI) affects individuals with Parkinson's disease (PD-MCI) and Alzheimer's disease (AD-MCI).
- Longitudinal comparisons between PD-MCI and AD-MCI are lacking.
- Understanding differences is crucial for diagnosis and management.
Purpose of the Study:
- To compare longitudinal characteristics of PD-MCI and AD-MCI.
- To identify distinct clinical and cognitive trajectories.
Main Methods:
- Utilized longitudinal data from the National Alzheimer's Coordinating Center's Uniform Data Set.
- Compared 41 PD-MCI and 191 AD-MCI participants on demographics, APOE e4 status, clinical factors, and cognitive tests.
- Employed multivariable linear regression with generalized estimating equations for analysis.
Main Results:
- PD-MCI and AD-MCI groups differed significantly in demographics and clinical features.
- Fewer PD-MCI participants progressed to dementia within one year compared to AD-MCI.
- PD-MCI participants showed better baseline and longitudinal performance on cognitive tests, including memory, language, and processing speed, and on the CDR-SB.
Conclusions:
- PD-MCI is clinically distinct from AD-MCI, necessitating tailored diagnostic and monitoring tools.
- PD-MCI appears to have a slower conversion rate to dementia than AD-MCI.
- Further research is needed to replicate these findings.
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