Non-dopaminergic treatment of cognitive impairment and dementia in Parkinson's disease: a review.
OBJECTIVE
To review the clinical management of cognitive impairment and dementia related to Parkinson's disease (PD), with emphasis on pharmacologic intervention strategies such as cholinesterase inhibitors.


METHODS
A MEDLINE, EMBASE, PsychINFO, and Cochrane Collaboration search of English language literature from 1970 to 2004 was performed to identify reviews, studies, case reports, and letters pertaining to the treatment of cognitive impairment in PD. The bibliographies of selected articles were reviewed for additional references.


METHODS
Human studies or case reports in adults with PD describing the use of drug and other therapies for the treatment of cognitive impairment in PD.


METHODS
Studies were reviewed for study design, number of subjects, outcome measures, dosage, side-effects, particularly, worsening of PD motor symptoms.


CONCLUSIONS
The strongest evidence for the pharmacological treatment of cognitive impairment and dementia in PD supports the use of cholinesterase inhibitors. Evidence for the efficacy and safety of other agents in PD dementia is either insufficient or inconclusive, but offers intriguing clues for potential future treatments. No reports from the Cochrane Collaboration were found.
Leroi
Iracema
I
Division of Psychiatry, University of Manchester, Manchester, United Kingdom. Ileroi2002@yahoo.co.uk
Collins
Deborah
D
Marsh
Laura
L
D000322:Adrenergic Agonists / Q000627:therapeutic use; D000978:Antiparkinson Agents / Q000145:classification / Q000627:therapeutic use*; D002800:Cholinesterase Inhibitors / Q000627:therapeutic use; D003072:Cognition Disorders / Q000209:etiology / Q000628:therapy*; D003704:Dementia / Q000209:etiology / Q000628:therapy*; D018691:Excitatory Amino Acid Antagonists / Q000627:therapeutic use; D006801:Humans; D016239:MEDLINE / Q000706:statistics & numerical data; D018696:Neuroprotective Agents / Q000627:therapeutic use; D010300:Parkinson Disease / Q000150:complications / Q000628:therapy*; D026741:Physical Therapy Modalities
D000322:Adrenergic Agonists; D000978:Antiparkinson Agents; D002800:Cholinesterase Inhibitors; D018691:Excitatory Amino Acid Antagonists; D018696:Neuroprotective Agents