Clinical phenotype of Parkinson disease dementia

@article{Galvin2006ClinicalPO,
  title={Clinical phenotype of Parkinson disease dementia},
  author={James E. Galvin and J. Pollack and John C. Morris},
  journal={Neurology},
  year={2006},
  volume={67},
  pages={1605 - 1611}
}
Objective: To determine which clinical features best characterize Parkinson disease dementia (PDD), compared with Alzheimer disease (AD) and dementia with Lewy bodies (DLB), and to determine the pathologic basis for PDD. Methods: We examined 103 participants enrolled in a longitudinal study (nondemented control = 10, PD = 42, DLB = 20, AD = 31) who were followed to autopsy using standardized protocols. We characterized the features of PDD using published criteria for AD and DLB as a framework… 

Tables from this paper

Parkinson Disease With Dementia: Comparing Patients With and Without Alzheimer Pathology

TLDR
It is suggested that it is difficult to distinguish PDD+AD and PDD−AD on the basis of movement, clinical, and neuropsychologic assessment.

Clinical utility of the clinical dementia rating scale for Parkinson’s disease dementia

TLDR
The results indicate the CDR is a useful tool in identifying dementia in patients with Parkinson’s disease when the cutoff scores are adjusted.

Pathologic Correlates of Dementia in Individuals with Lewy Body Disease

Cognitive impairment and dementia are more common in patients with Parkinson disease (PD) than age‐matched controls and appear to become more frequent as PD progresses. However, estimates of dementia

Cognitive Change in Parkinson Disease

  • J. Galvin
  • Psychology, Biology
    Alzheimer disease and associated disorders
  • 2006
TLDR
The clinical, cognitive, neuropsychiatric features of cognitive deficits associated with PD are examined, their pathologic basis is discussed, and avenues for future research are proposed.

Cognitive impairment in Parkinson's disease: Tools for diagnosis and assessment

TLDR
Further research on PD‐specific tools seems mandatory to help establish accurate cut‐off scores for the diagnosis of mild PDD, detect cognitive profiles more prone to the future development of dementia, and allow comparisons between different descriptive or interventional studies.

Crossover between Lewy Body Pathology and Alzheimer ’ s Dementia

TLDR
Clinical predictors of PDD are old age, severity of motor symptoms, in particular postural and gait disturbances, mild cognitive impairment, visual hallucinations and male gender.

Cognitive decline in Parkinson’s disease: the complex picture

TLDR
Evidence from neuroimaging studies using different methods and techniques suggests that in addition to degeneration of the dopaminergic system, other mechanisms have a role including β-amyloid and tau deposition, and that specific cognitive scales could help identifying a malignant profile.

Prevalence and impact of vascular and Alzheimer pathologies in Lewy body disease

TLDR
The data suggest an influence of Alzheimer-related lesions on the progression of the neurodegenerative process and, in particular, on cognitive decline in both PDD and DLB.

The Neuropathologic Substrate of Parkinson Disease Dementia

TLDR
A recent clinico-pathologic study confirmed essential clinical differences between PD with and without dementia and DLB: PDD patients were significantly older at death and had a shorter duration of illness and lower mini-mental status examination (MMSE) scores than non-demented PD cases.
...

References

SHOWING 1-10 OF 61 REFERENCES

Risk of dementia in Parkinson’s disease

TLDR
Patients with PD have an almost sixfold increased risk for becoming demented compared with subjects without PD.

Prevalence and characteristics of dementia in Parkinson disease: an 8-year prospective study.

TLDR
Early hallucinations and akinetic-dominant PD were associated with an increased risk of dementia, and more than three quarters of this representative PD cohort developed dementia during the 8-year study period.

Cognitive Predictors of Dementia in Parkinson’s Disease: A Community-Based, 4-Year Longitudinal Study

TLDR
It was concluded that poor performance on a test sensitive to executive dysfunction predicted later development of dementia in PD patients, and this finding may have important clinical implications as a marker of subsequentDevelopment of dementia.

Predictors of preclinical Alzheimer disease and dementia: a clinicopathologic study.

TLDR
Increased age, depressive features, and even minimal cognitive impairment, as determined clinically by Clinical Dementia Rating sum of boxes and by slowed psychomotor performance, identify older individuals without dementia who develop dementia.

Pathological basis for dementia in elderly patients with idiopathic Parkinson's disease.

TLDR
Based on neuropathological findings, damage not to a single, but to multiple neuronal networks including the innominatocortical cholinergic, ceruleocortICAL noradrenergic as well as mesocorticals dopaminergic systems could play a role in the development of dementia in PD.

Parkinson disease neuropathology: later-developing dementia and loss of the levodopa response.

TLDR
Diffuse or transitional Lewy body disease is the primary pathologic substrate for dementia developing later in Parkinson disease and seemed to account for end-stage, levodopa refractory parkinsonism, suggesting common origins or one triggering the other.

Motor impairment in PD

TLDR
It is suggested that motor impairment mediated predominantly by nondopaminergic systems is associated with incident dementia in PD and axial impairment may be the result of a combined effect of the disease and the aging process.

Mortality from Parkinson disease.

TLDR
Compared with nondemented elderly people in the same community, patients with PD have a 2- to 5-fold increased risk of mortality, and the risk is strongly related to the presence of severe EPSs, especially bradykinesia.

A controlled, longitudinal study of dementia in Parkinson's disease.

TLDR
The patients with PD who became demented during follow up were older at onset of Parkinson's disease than patients who did not become demented, had a longer duration of Parkinson’s disease, and were Older at inclusion to the study.

Mild cognitive impairment represents early-stage Alzheimer disease.

TLDR
It is concluded that MCI generally represents early-stage AD and individuals currently characterized as having MCI progress steadily to greater stages of dementia severity at rates dependent on the level of cognitive impairment at entry and they almost always have the neuropathologic features of AD.
...