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Cognitive decline in Parkinson’s disease: A prospective longitudinal study

Published online by Cambridge University Press:  01 May 2009

DINO MUSLIMOVIĆ ,
BART POST ,
JOHANNES D. SPEELMAN ,
ROB J. DE HAAN  and
BEN SCHMAND
DINO MUSLIMOVIĆ*
Affiliation:
Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
BART POST
Affiliation:
Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
JOHANNES D. SPEELMAN
Affiliation:
Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
ROB J. DE HAAN
Affiliation:
Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
BEN SCHMAND
Affiliation:
Department of Neurology, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands Department of Psychonomics, University of Amsterdam, Amsterdam, The Netherlands
*
*Correspondence and reprint requests to: Dino Muslimović, Department of Neurology, Academic Medical Centre, University of Amsterdam, H2-222, PO Box 22660, 1100 DD Amsterdam, The Netherlands. E-mail: [email protected]
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Abstract

This controlled prospective study examined the evolution and predictors of cognitive decline in Parkinson’s disease (PD). Consecutive patients diagnosed at baseline with PD (n = 89), established PD (EPD) patients (n = 52) with a mean disease duration of 6.5 years, and healthy control subjects (n = 64) underwent extensive neuropsychological assessment twice, approximately 3 years apart. A standardized regression-based method, normative data, and multivariate normative comparisons were used to assess the cognitive course of PD. Cognitive performance of newly diagnosed patients decreased significantly over time, particularly on measures of psychomotor speed and attention and to a lesser extent on tests of memory, visuospatial skills, and executive functions. About 50% of the patients showed cognitive decline and 9% developed dementia. Similar results were observed in EPD patients. None of the baseline features predicted cognitive change in newly diagnosed patients, whereas age at disease onset and axial impairment (postural and gait disorders) contributed to decline in established patients. We conclude that within few years after diagnosis, PD patients show faster rate of cognitive decline than matched healthy subjects, particularly in domains of attention and psychomotor speed. Selection bias probably led to underestimation of the true extent of cognitive decline in established patients. (JINS, 2009, 15, 426–437.)

Keywords

Parkinson’s diseaseCognitive impairmentNatural historyNeuropsychological testsLongitudinal designPrognostic factors
Type
Research Articles
Information
Journal of the International Neuropsychological Society , Volume 15 , Issue 3 , May 2009 , pp. 426 - 437
Copyright
Copyright © The International Neuropsychological Society 2009

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