Dementia and cognitive impairment in patients with Parkinson's disease from India: a 7-year prospective study.
Depression and cognitive impairment are frequent manifestations in Parkinson's disease (PD). Although a few longitudinal studies have reported on depression and dementia in PD, there is a yet a lack of such studies in India. This 7-year longitudinal study is a hospital-based prospective case (n = 250)-control (n = 280) study. In all, 36.8% had PD with no cognitive impairment (PD-Normal), 27.2% of the patients with PD were affected by dementia (PDD), and 36% of the remaining patients with PD had mild cognitive impairment (PD-MCI) at baseline. After 7 years of evaluation, 32 new patients, 12 patients from the PD-MCI group and 9 patients from the PD-Normal group, were diagnosed with dementia. The 7-year prevalence rate for dementia was estimated to be 49.28%. In the Indian population, an early onset of dementia is noted among patients with PD, with the age of onset being less than 55 years. Patients with early-onset PDD showed depression symptoms that differed significantly from the controls of the same age-group. There was a major difference in verbal fluency, word list recall, constructional praxis and recall, word list recognition, abridged Boston Naming Test, word list memory with repetition, and Mini-Mental State Examination between PD-MCI and PDD groups. Hallucinations before baseline (odds ratio [OR] = 4.427, 95% confidence interval [CI] = 2.122-9.373), akinetic/tremor dominancy (OR = 0.380, 95%CI = 0.149-0.953), and asymmetrical disease onset (OR = 0.3285, 95%CI = 0.1576-0.685) can be considered as risk factors for patients with dementia. Patients with early-onset PD might be more prone to complex depression and dementia. As the disease progresses, akinetic-dominant PD, early hallucinations, and asymmetrical disease onset are the potential risk factors for the development of dementia in patients with PD.
Department of Anthropology, University of Delhi, New Delhi-110007, India.
Jaya
J
Sanyal
Department of Neurology, National Neurosciences Centre, Kolkata, West Bengal, India.
Tapas Kumar
TK
Banerjee
Department of Anthropology, University of Delhi, New Delhi-110007, India parkinsons_research@rediffmail.com.
Vadlamudi Raghavendra
VR
Rao
D000368:Aged; D000369:Aged, 80 and over; D060825:Cognitive Dysfunction / Q000175:diagnosis / Q000209:etiology*; D003704:Dementia / Q000175:diagnosis / Q000209:etiology*; D003863:Depression / Q000175:diagnosis / Q000209:etiology / Q000523:psychology; D018450:Disease Progression; D005260:Female; D006801:Humans; D007194:India; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000175:diagnosis / Q000523:psychology*; D011446:Prospective Studies; D012307:Risk Factors
Parkinson’s disease; cognitive impairment; dementia; depression; longitudinal study