Abstract
Background: Cognitive impairment in Parkinson’s disease (PD) includes a spectrum varying from Mild Cognitive Impairment (PD-MCI) to PD Dementia (PDD). The main aim of the present study is to evaluate the incidence of PD-MCI, its rate of progression to dementia, and to identify demographic and clinical characteristics which predict cognitive impairment in PD patients.Methods: PD patients from a large hospital-based cohort who underwent at least two comprehensive neuropsychological evaluations were retrospectively enrolled in the study. PD-MCI and PDD were diagnosed according to the Movement Disorder Society criteria. Incidence rates of PD-MCI and PDD were estimated. Clinical and demographic factors predicting PD-MCI and dementia were evaluated using Cox proportional hazard model.Results: Out of 139 enrolled PD patients, 84 were classified with normal cognition (PD-NC), while 55 (39.6%) fulfilled the diagnosis of PD-MCI at baseline. At follow-up (mean follow-up 23.5 ± 10.3 months) 28 (33.3%) of the 84 PD-NC at baseline developed MCI and 4 (4.8%) converted to PDD. The incidence rate of PD-MCI was 184.0/1000 pyar (95% CI 124.7–262.3). At multivariate analysis a negative association between education and MCI development at follow-up was observed (HR 0.37, 95% CI 0.15–0.89; p = 0.03). The incidence rate of dementia was 24.3/1000 pyar (95% CI 7.7–58.5). Out of 55 PD-MCI patients at baseline, 14 (25.4%) converted to PDD, giving an incidence rate of 123.5/1000 pyar (95% CI 70.3–202.2). A five time increased risk of PDD was found in PD patients with MCI at baseline (RR 5.09, 95% CI 1.60–21.4).Conclusion: Our study supports the relevant role of PD-MCI in predicting PDD and underlines the importance of education in reducing the risk of cognitive impairment.
Highlights
Parkinson’s Disease (PD) has been classically considered a movement disorder, non-motor symptoms, such as cognitive impairment, represent very common features of the disease (Munhoz et al, 2015)
The main aim of the present study is to evaluate the incidence of PD-Mild Cognitive Impairment (MCI), its rate of progression to dementia, and to identify demographic and clinical characteristics which predict cognitive impairment in PD patients
Out of 55 PD-MCI patients at baseline, 14 (25.4%) converted to PD Dementia (PDD), giving an incidence rate of 123.5/1000 pyar
Summary
Parkinson’s Disease (PD) has been classically considered a movement disorder, non-motor symptoms, such as cognitive impairment, represent very common features of the disease (Munhoz et al, 2015). Cognitive impairment encompasses a spectrum varying from Mild Cognitive Impairment (MCI) to dementia, and MCI is considered as an intermediate condition between “normal aging” and dementia (Petersen et al, 2001). This concept was originally used to early capture subjects at risk to develop Alzheimer’s disease (Petersen et al, 2001), and recently was extended and adapted to PD patients (Litvan et al, 2012). Cognitive impairment in Parkinson’s disease (PD) includes a spectrum varying from Mild Cognitive Impairment (PD-MCI) to PD Dementia (PDD). The main aim of the present study is to evaluate the incidence of PD-MCI, its rate of progression to dementia, and to identify demographic and clinical characteristics which predict cognitive impairment in PD patients
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