Abstract
Background
Population-based assessments of cognitive function in patients with early Parkinson's
disease (PD) are rare. We examined whether patients with early PD have cognitive deficits
when compared with matched controls
Methods
All participants were age 65 years or older (median=76 years) and were enrolled in the Neurological Disorders in Central Spain (NEDICES)
study in central Spain. We identified all participants with early PD (<5 years duration) (N=46). These were matched to 138 controls. Neuropsychological test scores were compared
in PD patients vs. controls. In logistic regression models, we adjusted for the effects
of confounding variables. In these models, the dependent variable was the neuropsychological
test score (lowest quartile vs. all other quartiles) and the independent variable
was PD vs. control.
Results
Sixteen of 46 patients (34.8%) with early PD were previously undiagnosed. Subjective
memory complaint was present in 27 (58.7%) PD patients vs. 51 (37.0%) controls (p=0.010). In logistic regression models that adjusted for gender, education, and depressive
symptoms or antidepressant use, PD patients performed less well on the 37-item version
of the Mini-Mental State Examination (p=0.04), animal (p<0.001) and fruit fluency (p=0.04) as well as in a delayed free recall memory test (p=0.04) than controls.
Conclusions
In this population-based sample of older patients with early PD, the rate of subjective
and object cognitive impairment was appreciable. Patients with PD of less than five
years duration performed relatively poorly on tests of global cognition, verbal fluency
and memory. Clinicians should be vigilant to these cognitive difficulties even in
the early stages of PD.
Keywords
To read this article in full you will need to make a payment
Purchase one-time access:
Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online accessOne-time access price info
- For academic or personal research use, select 'Academic and Personal'
- For corporate R&D use, select 'Corporate R&D Professionals'
Subscribe:
Subscribe to Journal of the Neurological SciencesAlready a print subscriber? Claim online access
Already an online subscriber? Sign in
Register: Create an account
Institutional Access: Sign in to ScienceDirect
References
- Neuropsychological and clinical heterogeneity of cognitive impairment and dementia in patients with Parkinson's disease.Lancet Neurol. 2010; 9: 1200-1213
- Cognitive complaints in Parkinson's disease: its relationship with objective cognitive decline.J Neurol. 2010; 257: 79-84
- Cognitive impairments associated with early Parkinson's disease.Neurology. 1989; 39: 557-561
- Differential executive control impairments in early Parkinson's disease.J Neural Transm Suppl. 2004; 68: 39-51
- Cognitive profile of patients with newly diagnosed Parkinson disease.Neurology. 2005; 65: 1239-1245
- The cognitive ability of an incident cohort of Parkinson's patients in the UK. The CamPaIGN study.Brain. 2004; 127: 550-560
- Cognitive function in early Parkinson's disease: a population-based study.Eur J Neurol. 2009; 16: 1278-1284
- Cognitive impairment in incident, untreated Parkinson disease: the Norwegian ParkWest study.Neurology. 2009; 72: 1121-1126
- Prevalence of PD and other types of parkinsonism in three elderly populations of central Spain.Mov Disord. 2003; 18: 267-274
- Incidence of Parkinson disease and parkinsonism in three elderly populations of central Spain.Neurology. 2004; 64: 734-741
- Prevalence of essential tremor in three elderly populations of central Spain.Mov Disord. 2003; 18: 389-394
- Incidence of essential tremor in three elderly populations of central Spain.Neurology. 2005; 64: 1721-1725
- Prevalence of stroke and transient ischemic attack in three elderly populations of central Spain.Neuroepidemiology. 2008; 30: 247-253
- Cerebrovascular disease incidence in central Spain (NEDICES): a population-based prospective study.J Neurol Sci. 2010; 298: 85-90
- Consistency of clinical diagnosis of dementia in NEDICES: a population-based longitudinal study in Spain.J Geriatr Psychiatry Neurol. 2009; 22: 246-255
- Incidence and subtypes of dementia in three elderly populations of central Spain.J Neurol Sci. 2008; 264: 63-72
- Methods and demographic findings of the baseline survey of the NEDICES cohort: a door-to-door survey of neurological disorders in three communities from Central Spain.Public Health. 2004; 118: 426-433
- La cohorte de ancianos NEDICES. Metodología y principales hallazgos neurológicos.Rev Neurol. 2008; 46: 416-423
- Several factors influenced attrition in a population-based elderly cohort: neurological disorders in central Spain study.J Clin Epidemiol. 2010; 63: 215-222
- Self-reported depression and anti-depressant medication use in essential tremor: cross-sectional and prospective analyses in a population-based study.Eur J Neurol. 2007; 14: 1138-1146
- Population-based case–control study of morale in Parkinson's disease.Eur J Neurol. 2009; 16: 330-336
- Low morale is associated with increased risk of mortality in the elderly: a population-based prospective study (NEDICES).Age Ageing. 2010; 39: 366-373
- Risk of incident Parkinson's disease and parkinsonism in essential tremor: a population based study.J Neurol Neurosurg Psychiatry. 2009; 80: 423-425
- Parkinsonism: onset, progression, and mortality.Neurology. 1967; 17: 427-442
- The evolution of diagnosis in early Parkinson disease. Parkinson study group.Arch Neurol. 2000; 57: 369-372
- Development of simple cognitive function measures in a community dwelling population of elderly in Spain.Int J Geriatr Psychiatry. 2000; 15: 130-140
- Validation of a short cognitive tool for the screening of dementia in elderly people with low educational level.Int J Geriatr Psychiatry. 2003; 18: 925-936
- Population-based case–control study of cognitive function in essential tremor.Neurology. 2006; 66: 69-74
- A population-based study of cognitive function in older people with subjective memory complaints.J Alzheimers Dis. 2010; 22: 159-170
- Statins and cognitive functioning in the elderly: a population-based study.J Alzheimers Dis. 2010; 21: 95-102
- Elderly-onset essential tremor and mild cognitive impairment: a population-based study (NEDICES).J Alzheimers Dis. Feb 7 2011; 23: 727-735
- Cognitive versus functional screening for dementia across different countries: cross-cultural validation of the Mini-Mental State Examination (MMSE) and the Pfeffer activities questionnaire (PFAQ) against the standardised clinical diagnosis of dementia.Neurology. 2004; 44: A365
- “Mini-mental state”. A practical method for grading the cognitive state of patients for the clinician.J Psychiatr Res. 1975; 12: 189-198
- Selective memory impairment on an adapted Mini-Mental State Examination increases risk of future dementia.Int J Geriatr Psychiatry. 2004; 19: 1173-1180
- Elderly-onset essential tremor is associated with dementia.Neurology. 2006; 66: 1500-1505
- Risk of incident dementia in essential tremor: a population-based study.Mov Disord. 2007; 22: 1573-1580
- Total daily sleep duration and the risk of dementia: a prospective population-based study.Eur J Neurol. 2009; 16: 990-997
- Risk of incident dementia in drug-untreated arterial hypertension: a population-based study.J Alzheimers Dis. 2010; 22: 949-958
- Application of the Trail Making Test in differentiating neuropsychological impairment of elderly persons.Percept Mot Skills. 1985; 61: 1283-1289
- Verbal fluency in aging and dementia.J Clin Neuropsychol. 1980; 2: 135-146
- Wechsler Memory Scale — Revised.The Psychological Corporation, San Antonio, TX1987
- Estimation of premorbid intelligence in Spanish people with the Word Accentuation Test and its application to the diagnosis of dementia.Brain Cogn. 1997; 33: 343-356
- Subjective memory complaints may announce dementia.Neurology. 1996; 46: 121-125
- Hippocampal and prefrontal atrophy in patients with early non-demented Parkinson's disease is related to cognitive impairment.J Neurol Neurosurg Psychiatry. 2004; 75: 1467-1469
- Neuroanatomic basis of amnestic MCI differs in patients with and without Parkinson disease.Neurology. 2010; 75: 2009-2016
Article info
Publication history
Published online: July 21, 2011
Accepted:
June 29,
2011
Received in revised form:
June 1,
2011
Received:
March 2,
2011
Identification
Copyright
© 2011 Elsevier B.V. Published by Elsevier Inc. All rights reserved.
