title: Depression impairs executive functioning in Parkinson disease patients with low educational level.
abstract: OBJECTIVE
  To assess overall cognitive performance and executive functioning of nondemented Parkinson disease (PD) patients, and the influence of variables such as depression and education on cognition.
  
  
  BACKGROUND
  Cognitive dysfunction in PD is common even in early stages. Different variables have been identified as potential risk factors for cognitive decline in PD. Some of these variables, such as depression and educational level, are complexly interrelated.
  
  
  METHODS
  Eighty-two (male:female 52:30) subjects underwent clinical assessment which included the Unified Parkinson's Disease Rating Scale, Schwab-England Scale, Hoehn-Yahr Scale, Beck Depression Inventory, the Frontal Assessment Battery (FAB), and the Mini-Mental State Examination (MMSE).
  
  
  RESULTS
  Patients with higher education, younger age, and who had a younger age at disease onset performed better on both the FAB and MMSE. Severity of disease correlated with worse cognitive performance. Performance on the FAB, but not the MMSE, worsened with increased severity of depressive symptoms. When patients were divided into groups with lower (< or =4 y of schooling) and higher (> or =5 y of schooling) education, the FAB and Beck Depression Inventory correlated negatively only in the group with lower educational level.
  
  
  CONCLUSIONS
  Patients with PD present with cognitive impairment even when nondemented. Depression may exacerbate executive dysfunction, especially in subjects with lower educational level.
authors.affiliation: Department of Internal Medicine, Neurology Unit, University Hospital, School of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Minas Gerais, Brazil 30130-100.
authors.forename: Arthur
authors.initials: A
authors.lastname: Kummer
authors.forename: Estefânia
authors.initials: E
authors.lastname: Harsányi
authors.forename: Fernando M V
authors.initials: FM
authors.lastname: Dias
authors.forename: Francisco
authors.initials: F
authors.lastname: Cardoso
authors.forename: Paulo
authors.initials: P
authors.lastname: Caramelli
authors.forename: Antônio Lúcio
authors.initials: AL
authors.lastname: Teixeira
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D017668:Age of Onset; D003072:Cognition Disorders / Q000150:complications*; D003863:Depression / Q000150:complications*; D039721:Diagnostic and Statistical Manual of Mental Disorders; D004522:Educational Status; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications*; D011788:Quality of Life; D012307:Risk Factors; D012720:Severity of Illness Index