Anastasia Bougea1, Maria I Maraki1, Mary Yannakoulia1, Maria Stamelou1, Georgia Xiromerisiou1, Mary H Kosmidis1, Eva Ntanasi1, Efthimios Dardiotis1, Georgios M Hadjigeorgiou1, Paraskevi Sakka1, Costas A Anastasiou1, Leonidas Stefanis1, Nikolaos Scarmeas2. 1. From the 1st Department of Neurology (A.B., E.N., C.A.A., L.S., N.S.), Aiginition Hospital, National and Kapodistrian, University of Athens Medical School; Department of Nutrition and Dietetics (M.I.M., M.Y., E.N., C.A.A.), Harokopio University; Parkinson's Disease and Movement Disorders Department (M.S.), Hygeia Hospital, Athens, Greece; Department of Neurology (M.S.), Philipps University, Marburg, Germany; School of Medicine (G.X., E.D., G.M.H.), University of Thessaly, Larissa; Laboratory of Cognitive Neuroscience, School of Psychology (M.H.K.), Aristotle University of Thessaloniki, Greece; Department of Neurology (G.M.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (E.N., P.S.), Maroussi; Center of Clinical, Experimental Surgery and Translational Research (L.S.), Biomedical Research Foundation of the Academy of Athens, Greece; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY. 2. From the 1st Department of Neurology (A.B., E.N., C.A.A., L.S., N.S.), Aiginition Hospital, National and Kapodistrian, University of Athens Medical School; Department of Nutrition and Dietetics (M.I.M., M.Y., E.N., C.A.A.), Harokopio University; Parkinson's Disease and Movement Disorders Department (M.S.), Hygeia Hospital, Athens, Greece; Department of Neurology (M.S.), Philipps University, Marburg, Germany; School of Medicine (G.X., E.D., G.M.H.), University of Thessaly, Larissa; Laboratory of Cognitive Neuroscience, School of Psychology (M.H.K.), Aristotle University of Thessaloniki, Greece; Department of Neurology (G.M.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (E.N., P.S.), Maroussi; Center of Clinical, Experimental Surgery and Translational Research (L.S.), Biomedical Research Foundation of the Academy of Athens, Greece; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY. ns257@columbia.edu.
Abstract
OBJECTIVE: Given the limited information on cognitive function before Parkinson disease (PD) clinical onset in the general population, we sought to assess prodromal PD (pPD) probability and relate it to detailed cognitive performance in a community cohort. METHODS: In a population-based cohort of 1,629 dementia-free and PD-free participants ≥65 years of age in Greece, we assessed probability of pPD according to the International Parkinson and Movement Disorder Society's criteria. Clinical cognitive diagnoses (cognitively unimpaired, mild cognitive impairment [MCI], dementia) considering neuropsychological testing and functional status were assigned in consensus conferences. Cognitive performance in 5 cognitive domains was assessed by a detailed neuropsychological battery and summarized in the form of z scores. We investigated associations between pPD probability (and its individual constituents) and cognitive outcomes. RESULTS: The median probability of pPD was 1.81% (0.2%-96.7%). Participants with MCI had higher probability of pPD compared to those with normal cognition (p < 0.001). Higher probability of pPD was related to lower performance in all cognitive domains (memory, language, executive, attention, and visuospatial function) (p < 0.001). Lower cognitive performance was further associated with certain nonmotor markers of pPD, such as daytime somnolence, depression, urinary dysfunction, constipation, and subthreshold parkinsonism (p < 0.001). CONCLUSIONS: Higher probability of pPD was associated with lower cognitive performance in all domains and higher probability of MCI. This may reflect a widespread pathologic process although future studies are warranted to infer causality. These results suggest to clinicians that they should assess cognition early, and to researchers that they should further look into the possible mechanisms that may underlie this observation.
OBJECTIVE: Given the limited information on cognitive function before Parkinson disease (PD) clinical onset in the general population, we sought to assess prodromal PD (pPD) probability and relate it to detailed cognitive performance in a community cohort. METHODS: In a population-based cohort of 1,629 dementia-free and PD-free participants ≥65 years of age in Greece, we assessed probability of pPD according to the International Parkinson and Movement Disorder Society's criteria. Clinical cognitive diagnoses (cognitively unimpaired, mild cognitive impairment [MCI], dementia) considering neuropsychological testing and functional status were assigned in consensus conferences. Cognitive performance in 5 cognitive domains was assessed by a detailed neuropsychological battery and summarized in the form of z scores. We investigated associations between pPD probability (and its individual constituents) and cognitive outcomes. RESULTS: The median probability of pPD was 1.81% (0.2%-96.7%). Participants with MCI had higher probability of pPD compared to those with normal cognition (p < 0.001). Higher probability of pPD was related to lower performance in all cognitive domains (memory, language, executive, attention, and visuospatial function) (p < 0.001). Lower cognitive performance was further associated with certain nonmotor markers of pPD, such as daytime somnolence, depression, urinary dysfunction, constipation, and subthreshold parkinsonism (p < 0.001). CONCLUSIONS: Higher probability of pPD was associated with lower cognitive performance in all domains and higher probability of MCI. This may reflect a widespread pathologic process although future studies are warranted to infer causality. These results suggest to clinicians that they should assess cognition early, and to researchers that they should further look into the possible mechanisms that may underlie this observation.
Authors: Maria I Maraki; Alexandros Hatzimanolis; Niki Mourtzi; Leonidas Stefanis; Mary Yannakoulia; Mary H Kosmidis; Efthimios Dardiotis; Georgios M Hadjigeorgiou; Paraskevi Sakka; Alfredo Ramirez; Benjamin Grenier-Boley; Jean-Charles Lambert; Stefanie Heilmann-Heimbach; Maria Stamelou; Nikolaos Scarmeas; Georgia Xiromerisiou Journal: Front Mol Neurosci Date: 2021-12-21 Impact factor: 5.639
Authors: Mario H Flores-Torres; Katherine C Hughes; Samantha Molsberry; Xiang Gao; Jae H Kang; Michael A Schwarzschild; Alberto Ascherio Journal: BMJ Neurol Open Date: 2021-06-21