Abstract
An overview of studies on the issue of dementia in Parkinson's disease shows that, over time, there has been an evolution in the perception of the magnitude of the problem and of its nature. Dementia seems today to be part of the disease. This change in the understanding of the disease can be accounted for by various methodological problems and by difficulties, on one hand, in the definition of dementia and its differentiation from other conditions, and, on the other hand, in the diagnosis of the disease itself in individual cases. Optimal therapeutic strategies are also examined, either based on cholinesterase inhibitors or antiparkinsonian drugs and symptomatic measures.
Highlights
Speaking today about cognitive and behavioral disorders in Parkinson's disease (PD) means more and more speaking about dementia
James Parkinson described just 6 patients, one of them seen from a distance; he did not have the benefit of statistics! Other early writers denied the existence of cognitive decline
Neither was this the case just 20 years ago, when Brown and Marsden, in 1984, in their review of the research over the 60 years prior to 1984, found a number they judged inflated (35.1%, 1 in 3 patients with PD will be demented) [3]. They adjusted these figures to a more conservative estimate of one in five patients. They proposed an estimate of the rate of dementia in PD at the range of 15% to 20%, a risk some 10% to 15% higher than the expected risk of dementia in the general population
Summary
An essay on the shaking palsy London, Sherwood, Neely, and Jones, Paternoster Row; 1817.
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