Parkinson disease-associated cognitive impairment

doi:10.1038/s41572-021-00280-3

Review

. 2021 Jul 1;7(1):47.

doi: 10.1038/s41572-021-00280-3.

Parkinson disease-associated cognitive impairment

Dag Aarsland^{1

2}, Lucia Batzu³, Glenda M Halliday⁴, Gert J Geurtsen⁵, Clive Ballard⁶, K Ray Chaudhuri³, Daniel Weintraub^{7

8}

Affiliations

¹ Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. dag.aarsland@kcl.ac.uk.
² Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway. dag.aarsland@kcl.ac.uk.
³ Parkinson's Foundation Centre of Excellence, King's College Hospital and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁴ Brain and Mind Centre and Faculty of Medicine and Health School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia.
⁵ Amsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam Neuroscience, Amsterdam, The Netherlands.
⁶ University of Exeter Medical School, Exeter, UK.
⁷ Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
⁸ Parkinson's Disease Research, Education and Clinical Center (PADRECC), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.

PMID: 34210995
DOI: 10.1038/s41572-021-00280-3

Review

Parkinson disease-associated cognitive impairment

Dag Aarsland et al. Nat Rev Dis Primers. 2021.

. 2021 Jul 1;7(1):47.

doi: 10.1038/s41572-021-00280-3.

Authors

Dag Aarsland^{1

2}, Lucia Batzu³, Glenda M Halliday⁴, Gert J Geurtsen⁵, Clive Ballard⁶, K Ray Chaudhuri³, Daniel Weintraub^{7

8}

Affiliations

¹ Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK. dag.aarsland@kcl.ac.uk.
² Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway. dag.aarsland@kcl.ac.uk.
³ Parkinson's Foundation Centre of Excellence, King's College Hospital and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
⁴ Brain and Mind Centre and Faculty of Medicine and Health School of Medical Sciences, University of Sydney, Sydney, New South Wales, Australia.
⁵ Amsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam Neuroscience, Amsterdam, The Netherlands.
⁶ University of Exeter Medical School, Exeter, UK.
⁷ Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA.
⁸ Parkinson's Disease Research, Education and Clinical Center (PADRECC), Corporal Michael J. Crescenz Veterans Affairs Medical Center, Philadelphia, PA, USA.

PMID: 34210995
DOI: 10.1038/s41572-021-00280-3

Erratum in

Author Correction: Parkinson disease-associated cognitive impairment.
Aarsland D, Batzu L, Halliday GM, Geurtsen GJ, Ballard C, Ray Chaudhuri K, Weintraub D. Aarsland D, et al. Nat Rev Dis Primers. 2021 Jul 13;7(1):53. doi: 10.1038/s41572-021-00292-z. Nat Rev Dis Primers. 2021. PMID: 34257306 No abstract available.

Abstract

Parkinson disease (PD) is the second most common neurodegenerative disorder, affecting >1% of the population ≥65 years of age and with a prevalence set to double by 2030. In addition to the defining motor symptoms of PD, multiple non-motor symptoms occur; among them, cognitive impairment is common and can potentially occur at any disease stage. Cognitive decline is usually slow and insidious, but rapid in some cases. Recently, the focus has been on the early cognitive changes, where executive and visuospatial impairments are typical and can be accompanied by memory impairment, increasing the risk for early progression to dementia. Other risk factors for early progression to dementia include visual hallucinations, older age and biomarker changes such as cortical atrophy, as well as Alzheimer-type changes on functional imaging and in cerebrospinal fluid, and slowing and frequency variation on EEG. However, the mechanisms underlying cognitive decline in PD remain largely unclear. Cortical involvement of Lewy body and Alzheimer-type pathologies are key features, but multiple mechanisms are likely involved. Cholinesterase inhibition is the only high-level evidence-based treatment available, but other pharmacological and non-pharmacological strategies are being tested. Challenges include the identification of disease-modifying therapies as well as finding biomarkers to better predict cognitive decline and identify patients at high risk for early and rapid cognitive impairment.

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References

1. Zaman, V. et al. Cellular and molecular pathophysiology in the progression of Parkinson’s disease. Metab. Brain Dis. 36, 815–827 (2021). - PubMed - PMC
1. Aarsland, D. et al. Risk of dementia in Parkinson’s disease: a community-based, prospective study. Neurology 56, 730–736 (2001). - PubMed - PMC
1. Leroi, I., McDonald, K., Pantula, H. & Harbishettar, V. Cognitive impairment in Parkinson disease: impact on quality of life, disability, and caregiver burden. J. Geriatr. Psychiatry Neurol. 25, 208–214 (2012). - PubMed - PMC
1. Vossius, C., Larsen, J. P., Janvin, C. & Aarsland, D. The economic impact of cognitive impairment in Parkinson’s disease. Mov. Disord. 26, 1541–1544 (2011). - PubMed - PMC
1. Chandler, J. et al. Characteristics of Parkinson’s disease in patients with and without cognitive impairment. J. Parkinsons Dis. https://doi.org/10.3233/jpd-202190 (2021). - DOI - PubMed - PMC

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[1] Zaman, V. et al. Cellular and molecular pathophysiology in the progression of Parkinson’s disease. Metab. Brain Dis. 36, 815–827 (2021). - PubMed - PMC

[2] Zaman, V. et al. Cellular and molecular pathophysiology in the progression of Parkinson’s disease. Metab. Brain Dis. 36, 815–827 (2021). - PubMed - PMC

[3] Aarsland, D. et al. Risk of dementia in Parkinson’s disease: a community-based, prospective study. Neurology 56, 730–736 (2001). - PubMed - PMC

[4] Aarsland, D. et al. Risk of dementia in Parkinson’s disease: a community-based, prospective study. Neurology 56, 730–736 (2001). - PubMed - PMC

[5] Leroi, I., McDonald, K., Pantula, H. & Harbishettar, V. Cognitive impairment in Parkinson disease: impact on quality of life, disability, and caregiver burden. J. Geriatr. Psychiatry Neurol. 25, 208–214 (2012). - PubMed - PMC

[6] Leroi, I., McDonald, K., Pantula, H. & Harbishettar, V. Cognitive impairment in Parkinson disease: impact on quality of life, disability, and caregiver burden. J. Geriatr. Psychiatry Neurol. 25, 208–214 (2012). - PubMed - PMC

[7] Vossius, C., Larsen, J. P., Janvin, C. & Aarsland, D. The economic impact of cognitive impairment in Parkinson’s disease. Mov. Disord. 26, 1541–1544 (2011). - PubMed - PMC

[8] Vossius, C., Larsen, J. P., Janvin, C. & Aarsland, D. The economic impact of cognitive impairment in Parkinson’s disease. Mov. Disord. 26, 1541–1544 (2011). - PubMed - PMC

[9] Chandler, J. et al. Characteristics of Parkinson’s disease in patients with and without cognitive impairment. J. Parkinsons Dis. https://doi.org/10.3233/jpd-202190 (2021). - DOI - PubMed - PMC

[10] Chandler, J. et al. Characteristics of Parkinson’s disease in patients with and without cognitive impairment. J. Parkinsons Dis. https://doi.org/10.3233/jpd-202190 (2021). - DOI - PubMed - PMC

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Parkinson disease-associated cognitive impairment

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Parkinson disease-associated cognitive impairment

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