title: Cognition in individuals at risk for Parkinson's: Parkinson associated risk syndrome (PARS) study findings.
abstract: OBJECTIVE
  The Parkinson Associated Risk Syndrome Study identified a cohort of healthy adults with hyposmia and dopamine transporter binding reduction to characterize individuals at risk for Parkinson's disease (PD). We describe the cognitive profile of this cohort.
  
  
  METHODS
  Individuals older than 50 y without PD were recruited. Two hundred twenty-five completed cognitive testing and were included in the final analysis. A neuropsychological test battery was administered and normative scores created for global cognition, memory, executive function/working memory, processing speed/attention, visuospatial abilities, and language domains. Other non-motor symptoms (constipation, depression, anxiety, and rapid eye movement sleep behavior disorder) were assessed through questionnaires.
  
  
  RESULTS
  Individuals with both hyposmia and reduced dopamine transporter binding (n = 38) had lower mean scores for global cognition, executive function/working memory, and memory compared with all other participants (n = 187). In separate multivariate logistic regression models, lower global cognition (odds ratio, 1.97, P = 0.004), and specifically executive function/working memory (odds ratio, 1.84, P = 0.004) scores were associated with membership in the hyposmia with dopamine transporter reduction group. Combining hyposmia with relative impairment on specific cognitive domains increased the odds of dopamine transporter binding reduction compared with hyposmia alone, with the greatest increase in odds for hyposmia plus executive function/working memory relative impairment (68% increase in odds from 4.14 to 6.96).
  
  
  CONCLUSIONS
  Changes in global cognitive abilities, and specifically executive function/working memory, are present in individuals at risk for PD. Combining non-motor features, including cognition, improves prediction of dopamine transporter binding reduction.
authors: Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors: Lama M
authors: LM
authors: Chahine
authors: Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.|Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.|PD Research, Education and Clinical Center, Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA.
authors: Daniel
authors: D
authors: Weintraub
authors: Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.
authors: Keith A
authors: KA
authors: Hawkins
authors: Avid Radiopharmaceuticals, Philadelphia, Pennsylvania, USA.
authors: Andrew
authors: A
authors: Siderowf
authors: Department of Biostatistics, University of Rochester School of Medicine, Rochester, New York, USA.
authors: Shirley
authors: S
authors: Eberly
authors: Department of Biostatistics, University of Rochester School of Medicine, Rochester, New York, USA.
authors: David
authors: D
authors: Oakes
authors: The Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA.
authors: John
authors: J
authors: Seibyl
authors: Department of Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.
authors: Matthew B
authors: MB
authors: Stern
authors: The Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA.
authors: Kenneth
authors: K
authors: Marek
authors: The Institute for Neurodegenerative Disorders, New Haven, Connecticut, USA.
authors: Danna
authors: D
authors: Jennings
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001007:Anxiety / Q000209:etiology; D001288:Attention / Q000502:physiology; D003042:Cocaine / Q000031:analogs & derivatives / Q000493:pharmacokinetics; D003072:Cognition Disorders / Q000175:diagnosis* / Q000209:etiology*; D015331:Cohort Studies; D056344:Executive Function; D005260:Female; D006801:Humans; D007802:Language; D008297:Male; D008568:Memory; D008875:Middle Aged; D055496:Neurogenic Bowel / Q000209:etiology; D009483:Neuropsychological Tests; D000857:Olfaction Disorders / Q000209:etiology; D010300:Parkinson Disease / Q000150:complications* / Q000000981:diagnostic imaging; D011485:Protein Binding / Q000187:drug effects; D019275:Radiopharmaceuticals / Q000493:pharmacokinetics; D057566:Self Report; D012720:Severity of Illness Index; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires; D015899:Tomography, Emission-Computed, Single-Photon; D014796:Visual Perception / Q000502:physiology
chemical_list: D019275:Radiopharmaceuticals; C069723:2beta-carbomethoxy-3beta-(4-iodophenyl)tropane; D003042:Cocaine
keywords: Parkinson's; cognition; dopaminergic deficit; hyposmia; prodromal