title: Vascular Risk Factors and Cognition in Parkinson's Disease.
abstract: Vascular risk factors have been associated with cognitive deficits and incident dementia in the general population, but their role on cognitive dysfunction in Parkinson's disease (PD) is still unclear. The present study addresses the single and cumulative effect of vascular risk factors on cognition in PD patients, taking clinical confounders into account. Standardized neuropsychological assessment was performed in 238 consecutive PD patients. We evaluated the association of single and cumulative vascular risk factors (smoking, diabetes, hypercholesterolemia, hypertension, and heart disease), with the diagnosis of PD normal cognition (PDNC, n = 94), mild cognitive impairment (PD-MCI, n = 111), and dementia (PDD, n = 33). The association between single neuropsychological tests and vascular risk factors was evaluated with covariance analyses adjusted for age at onset, educational levels, gender, disease duration, and motor performance. Age, educational levels, disease duration, and motor function were significantly different between PDNC, PD-MCI, and PDD. Heart disease was the only vascular factor significantly more prevalent in PDD compared with PDNC in adjusted analyses. Performance of tests assessing executive and attention functions were significantly worse in patients with hypertension, heart disease, and/or diabetes (p <  0.05). Heart disease is associated with dementia in PD, suggesting a potential window of intervention. Vascular risk factors act especially on attention and executive functions in PD. Vascular risk stratification may be useful in order to identify PD patients with a greater risk of developing dementia. These findings need to be verified in longitudinal studies.
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.|Department of Neurodegeneration, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany.
authors.forename: Andrea
authors.initials: A
authors.lastname: Pilotto
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Rosanna
authors.initials: R
authors.lastname: Turrone
authors.affiliation: Department of Neurodegeneration, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany.|German Centre for Neurodegenerative Diseases, Tübingen, Germany.
authors.forename: Inga
authors.initials: I
authors.lastname: Liepelt-Scarfone
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Marta
authors.initials: M
authors.lastname: Bianchi
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Loris
authors.initials: L
authors.lastname: Poli
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Borroni
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Alberici
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.|Neurovascular Unit, Brescia Hospital, Italy.
authors.forename: Enrico
authors.initials: E
authors.lastname: Premi
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Anna
authors.initials: A
authors.lastname: Formenti
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Bigni
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Maura
authors.initials: M
authors.lastname: Cosseddu
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Cottini
authors.affiliation: Department of Neurodegeneration, Hertie Institute of Clinical Brain Research, University of Tübingen, Tübingen, Germany.|German Centre for Neurodegenerative Diseases, Tübingen, Germany.
authors.forename: Daniela
authors.initials: D
authors.lastname: Berg
authors.affiliation: Neurology Unit, Department of Clinical and Experimental Sciences, University of Brescia, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Padovani
mesh_terms: D017668:Age of Onset; D000368:Aged; D001288:Attention; D004185:Disability Evaluation; D004522:Educational Status; D056344:Executive Function; D005260:Female; D006801:Humans; D008297:Male; D009043:Motor Activity; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D013997:Time Factors; D014652:Vascular Diseases / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology
keywords: Dementia; Parkinson disease; heart disease; hypertension; risk factors