title: Mild cognitive impairment in Parkinson's disease.
abstract: The concept of mild cognitive impairment (MCI) in the general population has received increased attention over recent years, and is associated with risk of progression to Alzheimer's disease. Within Parkinson's disease (PD), MCI (PD-MCI) is also now recognised to be relatively common, with certain subtypes predicting progression to Parkinson's disease dementia (PDD). Recently, criteria to better characterise PD-MCI and its subtypes have been produced by the Movement Disorder Society. In contrast to the population as a whole, where amnestic MCI is the most common subtype, non-amnestic PD-MCI dominates, with prominent executive and attention dysfunction. Although the pathophysiology of PD-MCI is poorly understood and encompasses both PD and non-PD pathology, it is most likely the result of a complex interaction between neurotransmitter dysfunction, synaptic pathology, protein aggregation and neuronal damage. Determining the factors that influence the progression of these pathologies in PD and the individuals at risk of ultimately developing PDD is critical for targeted intervention and drug discovery studies. Further work is required, however, to determine the significance of PD-MCI and also to validate the diagnostic criteria. This would be best delivered in the form of longitudinal studies in homogenous cohorts of PD participants, to allow prognostication and generalisation among the PD population. At the present time, no drug therapies are available for PD-MCI. Management includes screening for the disorder, excluding treatable causes of cognitive decline and cautious use of dopamine agonists and medications such as anticholinergics.
authors.affiliation: Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle upon Tyne, Tyne and Wear NE4 5PL, UK. alison.yarnall@ncl.ac.uk
authors.forename: Alison Jane
authors.initials: AJ
authors.lastname: Yarnall
authors.forename: Lynn
authors.initials: L
authors.lastname: Rochester
authors.forename: David John
authors.initials: DJ
authors.lastname: Burn
mesh_terms: D000367:Age Factors; D000375:Aging / Q000523:psychology; D000978:Antiparkinson Agents / Q000627:therapeutic use; D003071:Cognition / Q000187:drug effects; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D003704:Dementia / Q000453:epidemiology / Q000523:psychology; D018450:Disease Progression; D006801:Humans; D018697:Nootropic Agents / Q000627:therapeutic use; D010300:Parkinson Disease / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors
chemical_list: D000978:Antiparkinson Agents; D018697:Nootropic Agents
keywords: Parkinson's disease; amyloid; dementia; mild cognitive impairment; older people