Predictors of cognitive impairment in advanced Parkinson's disease.
OBJECTIVE
To investigate the cognitive profile of patients with idiopathic Parkinson's disease and to determine the demographic and medical variables that contribute to the cognitive outcome.


METHODS
Retrospective cohort analysis.


METHODS
100 patients with idiopathic Parkinson's disease were given a neuropsychological test battery investigating attention, memory, and visuospatial and executive functions. Test performance was compared against normative data, and linear regression determined significant predictors of cognitive impairment from a set of demographic and disease course variables.


RESULTS
Frontal-type cognitive dysfunction was widespread in patients with advanced Parkinson's disease. Attention and memory were mildly to moderately impaired, whereas visuospatial function showed only subtle impairment. Older age and tremor at onset were significant predictors of poor cognitive performance.


CONCLUSIONS
The observed cognitive impairment in patients with advanced Parkinson's disease is more than expected for normal aging. Although in apparent contrast with most previous research, reporting a greater risk of cognitive dysfunction in Parkinson's disease patients with predominant akinesia/rigidity, tremor at onset may be a marker for more widespread brain pathology that contributes to an increased risk of cognitive impairment.
Vingerhoets
G
G
Laboratory for Neuropsychology, Ghent University, Ghent, Belgium. guy.vingerhoets@rug.ac.be
Verleden
S
S
Santens
P
P
Miatton
M
M
De Reuck
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology*; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications*; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012720:Severity of Illness Index