Abstract
Purpose: The purpose of this systematic review of the literature is to examine the cerebrovascular and cardiovascular effects on cognition in persons with Parkinson’s disease. Relevance: Physical therapy treatment of persons with Parkinson’s disease (PD) has traditionally focused on lessening the impact of disease severity by improving quality of life and functional capacity. Research has shown that quality of life in persons with PD is not only significantly affected by motor symptoms, but also by the presence of defined non-motor symptoms such as cerebrovascular perfusion, cardiovascular dysfunction, and cognitive impairment. This study seeks to determine a causative effect among these non-motor symptoms with the intention to better manage cognitive impairment in persons with PD. Methods: A literature search was conducted utilizing the following databases: Scopus, PubMed, and CINAHL. After evaluating and grading studies using the Downs and Black Checklist, a total of seven studies remained for the final review. Results: Five common domains of cognition emerged throughout the seven studies: executive function, attention, verbal memory and fluency, visual memory, and working memory. Considering the articles reviewed, a relationship between cerebrovascular and cardiovascular deficiency and cognitive impairment in persons with PD was established. Conclusions: Persons with PD and certain cerebrovascular and cardiovascular risk factors, including orthostatic hypotension and systemic hypertension, should be referred to appropriate professionals for comprehensive neuropsychological testing secondary to an increased risk for more severe cognitive deficit.
Highlights
Parkinson’s disease (PD) is a progressive, neurodegenerative disease characterized by both motor and non-motor symptoms
Having established that impaired perfusion negatively impacts cognitive function, it can be inferred that those persons with PD who have altered BP will display cognitive impairments
It is the contention of this literature review that persons with PD and co-morbid cerebrovascular or cardiovascular impairments will benefit from early cognitive screening with an appropriate neuropsychological testing battery
Summary
Parkinson’s disease (PD) is a progressive, neurodegenerative disease characterized by both motor and non-motor symptoms. PD is typically associated with four hallmark motor symptoms: resting tremor, rigidity, bradykinesia, and postural instability [2]. In addition to these motor symptoms, several studies have identified the existence of non-motor symptoms and their impacts on persons with PD [3]-[6]. Research shows that many of these non-motor symptoms persist from diagnosis through the advanced stages of PD. These symptoms remain untreated by typical PD medical management and can have a profound impact on quality of life (QOL) [3]-[6]
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