title: Longitudinal assessment of the pattern of cognitive decline in non-demented patients with advanced Parkinson's disease.
abstract: BACKGROUND
  Dementia and mild cognitive impairment (MCI) are frequent in Parkinson's disease (PD). Deficits in some cognitive tests are considered risk factors for dementia in PD. However, how cognitive deficits progress in aged and long-lasting non-demented PD is not known.
  
  
  OBJECTIVE
  To study the rate and pattern of progression of cognitive deficits in aged and long-lasting non-demented PD.
  
  
  METHODS
  Forty-nine non-demented patients (23 cognitively normal (PD-CN) and 26 with MCI (PD-MCI)) were studied over 31 months using individual tests and z-scores covering five cognitive domains. All patients were at least 60 year old and have had PD ≥ 10 years.
  
  
  RESULTS
  Attention, executive function and memory worsened in 5 PD-CN patients who progressed to MCI (21.7% of the sample) and in 1 patient who became demented (4.3% of the sample). Eleven PD-MCI patients who developed dementia (42.3% of the sample) showed aggravation of visuospatial, executive and attention domains. Multidomain-MCI and poor execution of Stroop-Words, copy of intersecting pentagons and Raven Progressive Matrices tests were associated with conversion to dementia.
  
  
  CONCLUSIONS
  This pilot study shows that in long-lasting PD 21.7% of PD-CN patients progress to MCI and 42.3% of PD-MCI progress to dementia over a 31 months observation period. The transition from cognitively normal to MCI is featured by attention, executive and memory dysfunction and the evolution from MCI to dementia is marked by the appearance of visuospatial deficits and worsening of attention and executive function. These data are compatible with the concept that cognitive decline in PD follows a distinct dysfunction pattern with progressive anterior to posterior cortical involvement.
authors.affiliation: Neurosciences Area, CIMA, Department of Neurology and Neurosurgery, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.
authors.forename: Carmen
authors.initials: C
authors.lastname: Gasca-Salas
authors.affiliation: Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain Department of Neurology and Neuroscience, University Hospital Donostia, BioDonostia Research Institute, San Sebastian, Spain.
authors.forename: Ainara
authors.initials: A
authors.lastname: Estanga
authors.affiliation: Neurosciences Area, CIMA, Department of Neurology and Neurosurgery, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain.
authors.forename: Pedro
authors.initials: P
authors.lastname: Clavero
authors.affiliation: Departamento de Microbiología, Medicina Preventiva y Salud Pública, Facultad de Medicina, Universidad de Zaragoza, Zaragoza, Spain.
authors.forename: Isabel
authors.initials: I
authors.lastname: Aguilar-Palacio
authors.affiliation: Neurosciences Area, CIMA, Department of Neurology and Neurosurgery, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.
authors.forename: Rafael
authors.initials: R
authors.lastname: González-Redondo
authors.affiliation: Neurosciences Area, CIMA, Department of Neurology and Neurosurgery, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.
authors.forename: Jose A
authors.initials: JA
authors.lastname: Obeso
authors.affiliation: Neurosciences Area, CIMA, Department of Neurology and Neurosurgery, Clínica Universidad de Navarra, University of Navarra, Pamplona, Spain Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain.
authors.forename: Maria C
authors.initials: MC
authors.lastname: Rodríguez-Oroz
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D018450:Disease Progression; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications*; D011569:Psychiatric Status Rating Scales
keywords: Mild cognitive impairment; Parkinson's disease; dementia; progression