Abstract
James Parkinson described “the shaking palsy” as a disease with “involuntary tremulous motion, with lessened muscular power, in parts not in action and even when supported; with a propensity to bend the trunk forwards, and to pass from a walking to a running pace: the senses and intellects being uninjured.”1 The motor signs were described well, but dementia was notably and actively omitted in the original description. For patients with Parkinson disease (PD) today, the question of whether they will develop dementia remains difficult to address early in the course of the disease, and the open question contributes to anxiety. Almost all patients with PD exhibit subcortical cognitive dysfunction and up to 80% of patients with PD develop significant enough cognitive deficits to meet the criteria for dementia.2 In this issue of Neurology ®, Klassen et al.3 describe a potential biomarker for identifying dementia in PD, possibly bringing us closer to addressing one of our patients' major worries. A sample of 117 dementia-free subjects were prospectively evaluated over a 9-year period. During …
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