Cognitive Influences in Parkinson's Disease Patients and Their Caregivers: Perspectives From an Australian Cohort.

Michal Lubomski,Ryan L Davis,Carolyn M Sue

doi:10.3389/fneur.2021.673816

Abstract

Objectives: Cognitive impairment impacts negatively on Parkinson's disease (PD) patient and caregiver quality of life (QoL). We examined cognitive impairment in PD patients and their caregivers to determine if caregiver cognition affected their PD relative.Methods: Validated cognition and clinical outcome measures were assessed in 103 PD patients and 81 caregivers.Results: PD patients showed more cognitive impairment than their carers, with 48.6% having possible Mild Cognitive Impairment (MCI) and 16.5% having PD dementia. Increasing age, male gender, lower education level, various non-motor symptoms and certain therapies, associated with poorer cognition in PD. Eighteen and a half percent of caregivers were found to have MCI, in association with a lower physical and mental QoL. This reflected in lower QoL and mood for the respective PD patients.Conclusion: Impaired cognition and QoL in caregivers was associated with decreased QoL and mood for respective PD patients, suggesting MCI in caregivers is an important consideration for the management of PD.

Highlights

Parkinson’s disease (PD) is a progressive multisystem disorder that contributes to significant morbidity, healthcare and caregiver burden [1, 2]
Half of the PD individuals and one fifth of their caregivers met the criteria for possible mild cognitive impairment (MCI), whilst 16.5% of PD patients met the criteria for PD Dementia (PDD)
Our findings suggest that nearly a fifth of the PD caregivers in this study met the criteria for MCI, inferring a potential challenge for those with MCI being able to care for a spouse or relative with cognitive impairment

Summary

Introduction

Parkinson’s disease (PD) is a progressive multisystem disorder that contributes to significant morbidity, healthcare and caregiver burden [1, 2]. Cognitive impairment can be present in as many as 30% of PD patients at disease onset, progressing to PD Dementia (PDD) in up to 80% of patients with advanced disease [3]. The concept of mild cognitive impairment (MCI) is an intermediate clinical state between normal cognitive ageing and dementia [4]. MCI represents an important window in time where patients are still functional in their day to day life but are at a higher risk of developing PDD [5]. It has been suggested that PD caregivers experience a higher burden of care leading to reduced quality of life (QoL) with the onset of dementia in their PD relative [11], influencing PD management and delaying formal care or nursing home placement [12].

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Methods

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Discussion

Conclusion