Abstract
Our objectives were to perform a longitudinal assessment of mental status in early stage Parkinson's disease (PD) patients, with brief neuropsychological tests, in order to find predictive factors for cognitive decline. Sixty-one, early stage, and nondemented patients were assessed twice, over a 2-year interval, with a global cognitive test (mini-mental state examination (MMSE)) and a frontal function test (frontal assessment battery (FAB)) and motor function scales. Dementia and hallucinations were diagnosed according to the DSM-IV criteria. Cognitive function scores did not decrease significantly, except for FAB lexical fluency score. Four patients presented with dementia at followup. The MMSE score below cut-off, worse gait dysfunction, the nontremor motor subtype, and hallucinations were significantly related to dementia. Rigidity and speech dysfunction were related to dementia and a decrease in FAB scores. We can conclude that decline in the MMSE and FAB scores is small and heterogeneous in the early stages of PD. Scores below cut-off in the MMSE could be helpful to predict dementia. Nontremor motor deficits could be predictive factors for frontal cognitive decline and dementia.
Highlights
Parkinson’s disease is a movement disorder, defined by a combination of tremor, rigidity, bradykinesia, and gait disturbances [1]
We found that early stage, nondemented Parkinson’s disease (PD) patients presented with significantly lower scores in the frontal assessment battery (FAB) and the mini-mental state examination (MMSE), when compared to non-PD aged controls, and that MMSE scores were related to nontremor motor scores [7]
The early stage PD was defined as disease duration up to 5 years and the Hoehn and Yahr [8] (HY) stage from 1 to 2.5, included, at baseline
Summary
Parkinson’s disease is a movement disorder, defined by a combination of tremor, rigidity, bradykinesia, and gait disturbances [1]. Brief cognitive tests could be useful for a rapid screening of patients at higher risk for cognitive decline. They could be of use for following cognitive decline and predicting cognitive outcome. Noncognitive symptoms at the baseline, like motor dysfunction severity, or specific motor symptoms could be useful as cognitive outcome predictors. We found that early stage, nondemented PD patients presented with significantly lower scores in the frontal assessment battery (FAB) and the mini-mental state examination (MMSE), when compared to non-PD aged controls, and that MMSE scores were related to nontremor motor scores [7]. Our objectives were to perform a longitudinal analysis of this cohort, in order to assess the relation between motor and cognitive performance at baseline and cognitive dysfunction progression
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