Julius B M Anang1, Jean-Francois Gagnon2, Josie-Anne Bertrand1, Silvia Rios Romenets1, Veronique Latreille1, Michel Panisset1, Jacques Montplaisir1, Ronald B Postuma2. 1. From the Department of Neurology and Neurosurgery (J.B.M.A., S.R.R., R.B.P.), McGill University, Montreal; Centre d'Études Avancées en Médecine du Sommeill (J.-F.G., J.-A.B., V.L., M.P., J.M., R.B.P.), Hôpital du Sacré-coeur de Montréal; Department of Psychology (J.-F.G., J.-A.B.), Université du Québec à Montréal; and Department of Psychiatry (J.M.), Université de Montreal, Canada. 2. From the Department of Neurology and Neurosurgery (J.B.M.A., S.R.R., R.B.P.), McGill University, Montreal; Centre d'Études Avancées en Médecine du Sommeill (J.-F.G., J.-A.B., V.L., M.P., J.M., R.B.P.), Hôpital du Sacré-coeur de Montréal; Department of Psychology (J.-F.G., J.-A.B.), Université du Québec à Montréal; and Department of Psychiatry (J.M.), Université de Montreal, Canada. ron.postuma@mcgill.ca gagnon.jean-francois.2@uqam.ca.
Abstract
OBJECTIVE: We investigated an array of possible markers of early dementia in Parkinson disease. METHODS: We performed a comprehensive assessment of autonomic, sleep, psychiatric, visual, olfactory, and motor manifestations in 80 patients with Parkinson disease who were dementia-free at baseline. After 4.4 years' follow-up, patients were evaluated for dementia. Predictive variables were assessed using logistic regression adjusting for disease duration, follow-up duration, age, and sex. RESULTS: Of 80 patients, 27 (34%) developed dementia. Patients destined to develop dementia were older and more often male (odds ratio [OR] = 3.64, p = 0.023). Those with baseline mild cognitive impairment had increased dementia risk (OR = 22.5, p < 0.001). REM sleep behavior disorder at baseline dramatically increased dementia risk (OR = 49.7, p = 0.001); however, neither daytime sleepiness nor insomnia predicted dementia. Higher baseline blood pressure increased dementia risk (OR = 1.37 per 10 mm Hg, p = 0.032). Orthostatic blood pressure drop was strongly associated with dementia risk (OR = 1.84 per 10 mm Hg, p < 0.001); having a systolic drop of >10 mm Hg increased dementia odds 7-fold (OR = 7.3, p = 0.002). Abnormal color vision increased dementia risk (OR = 3.3, p = 0.014), but olfactory dysfunction did not. Among baseline motor variables, proportion of gait involvement (OR = 1.12, p = 0.023), falls (OR = 3.02, p = 0.042), and freezing (OR = 2.63, p = 0.013), as well as the Purdue Pegboard Test (OR = 0.67, p = 0.049) and alternate tap test (OR = 0.97, p = 0.033) predicted dementia. CONCLUSION: Cardiovascular autonomic dysfunction, REM sleep behavior disorder, color discrimination ability, and gait dysfunction strongly predict development of dementia in Parkinson disease.
OBJECTIVE: We investigated an array of possible markers of early dementia in Parkinson disease. METHODS: We performed a comprehensive assessment of autonomic, sleep, psychiatric, visual, olfactory, and motor manifestations in 80 patients with Parkinson disease who were dementia-free at baseline. After 4.4 years' follow-up, patients were evaluated for dementia. Predictive variables were assessed using logistic regression adjusting for disease duration, follow-up duration, age, and sex. RESULTS: Of 80 patients, 27 (34%) developed dementia. Patients destined to develop dementia were older and more often male (odds ratio [OR] = 3.64, p = 0.023). Those with baseline mild cognitive impairment had increased dementia risk (OR = 22.5, p < 0.001). REM sleep behavior disorder at baseline dramatically increased dementia risk (OR = 49.7, p = 0.001); however, neither daytime sleepiness nor insomnia predicted dementia. Higher baseline blood pressure increased dementia risk (OR = 1.37 per 10 mm Hg, p = 0.032). Orthostatic blood pressure drop was strongly associated with dementia risk (OR = 1.84 per 10 mm Hg, p < 0.001); having a systolic drop of >10 mm Hg increased dementia odds 7-fold (OR = 7.3, p = 0.002). Abnormal color vision increased dementia risk (OR = 3.3, p = 0.014), but olfactory dysfunction did not. Among baseline motor variables, proportion of gait involvement (OR = 1.12, p = 0.023), falls (OR = 3.02, p = 0.042), and freezing (OR = 2.63, p = 0.013), as well as the Purdue Pegboard Test (OR = 0.67, p = 0.049) and alternate tap test (OR = 0.97, p = 0.033) predicted dementia. CONCLUSION:Cardiovascular autonomic dysfunction, REM sleep behavior disorder, color discrimination ability, and gait dysfunction strongly predict development of dementia in Parkinson disease.
Authors: C Peralta; M Stampfer-Kountchev; E Karner; M Köllensperger; F Geser; E Wolf; K Seppi; T Benke; W Poewe; G K Wenning Journal: J Neural Transm (Vienna) Date: 2007-01-03 Impact factor: 3.575
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Authors: Wojciech Gryc; Kathryn A Roberts; Cyrus P Zabetian; Daniel Weintraub; John Q Trojanowski; Joseph F Quinn; Amie L Hiller; Kathryn A Chung; Kathleen L Poston; Laurice Yang; Shu-Ching Hu; Karen L Edwards; Thomas J Montine; Brenna A Cholerton Journal: J Parkinsons Dis Date: 2020 Impact factor: 5.568