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Parkinson’s disease (PD) is characterized by motor and non-motor symptoms including cognitive, autonomic, sleep, and sensory disturbances. Cognitive impairment may occur in up to 80% of PD patients, and dementia in approximately 30%. The purpose of this study is to evaluate the frequency of cognitive impairment and the characteristics of cognitive deficits and to know the possibility of early detection of cognitive deficits in outpatient clinics with the questionnaire for patients and caregivers.
A total of 129 consecutive patients with idiopathic Parkinson’s disease were visited movement clinic from March 2006 to August 2006. Eighty-five patients performed cognitive test and questionnaires. All patients had motor symptoms with Hoehn and Yahr stage 0.5 to 3 (mean: 1.98±0.617), and evaluated with cognition by K-MMSE (Korean version of Mini-mental status examination), 7-MS (7-minutes screen test), and demographic features.
The frequency of cognitive impairment in PD patients was 44.7% (38/85), among them thirty (78.9%) patients complained memory disturbance. The characteristics of cognitive test were retrieval defect in memory, visuospatial dysfunction and categorical word fluency. With questionnaire, the complaint of memory decline and difficulties in activity of daily living (ADL) w ere important points of cognitive deficit in PD patients. However questionnaire did not showed significant correlation between complain of memory decline and cognitive deficit, only regular check with cognitive function test revealed the patient’s early cognitive impairment.
The cognitive impairment was frequent in PD patients. The characteristics of cognitive testing w ere retrieval defect in memory function and frontal executive dysfunction.
To determine the frequency of mild cognitive impairment (MCI) of Parkinson’s disease (PD, PDMCI) and its subtypes among non-demented PD patients, and to identify the influence of the age and presenting symptom on the development of PDMCI.
A total 141 non-demented PD patients underwent a comprehensive neuropsychological assessment including attention, language, visuospatial, memory and frontal functions. PDMCI was defined by neuropsychological testing and was classified into five subtypes. Patients were divided into two groups (tremor vs. akinetic-rigid type) for presenting symptom and three groups according to the age. Neuropsychological performance of patients was compared with normative data.
Almost half (49.6%) of non-demented PD patients had impairment in at least one domain and can be considered as having PDMCI. Executive type of PDMCI was the most frequent and amnestic, visuospatial, linguistic and attention types followed in the order of frequency. The population of PDMCI was increasing as the age of disease onset was higher. Whereas the frequency of executive and amnestic types of PDMCI was comparable in younger group, executive type was the most frequent in older group. The patients with tremor dominant type performed worse on tests, particularly on attention test.
MCI was common even in the early stage of PD and the subtype was diverse. Unlike MCI developing Alzheimer’s disease later, executive type of PDMCI was the most common. Age was an important risk factor for development of MCI in PD. The concept of MCI should be introduced in PD.
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