Screening for cognitive impairment in Parkinson’s disease – which marker relates to disease severity?
First Online: 11 April 2006 Received: 05 October 2005 Accepted: 22 January 2006 DOI:
10.1007/s00702-006-0433-6 Cite this article as: Riepe, M., Kassubek, J., Tracik, F. et al. J Neural Transm (2006) 113: 1463. doi:10.1007/s00702-006-0433-6 Summary.
The frequency and pattern of cognitive deficits in Parkinson’s disease (PD) is under discussion. We assessed 157 consecutive subjects with PD (66.4 ± 8.9 years (mean ± standard deviation); average duration of disease 3.5 ± 1.3 years; average Hoehn and Yahr stage 2.4 ± 0.9) diagnosed in centers specialized for the diagnosis and treatment of PD with brief tests for memory (Memory Impairment Screen), attention (Letter Sorting Test) and semantic fluency (category animals). Impaired memory was observed in about one half of the subjects regardless of severity of disease as assessed by staging according to Hoehn and Yahr. With greater severity, free recall was impaired and subjects required the cues to recall the items. Performance in the Letter Sorting Test and the semantic fluency task declined with increasing Hoehn and Yahr stage, also. We conclude that cognitive deficits are frequent in PD. Further analyses reveal that even in selected screening tests (e.g. semantic fluency) a significant impairment with increasing disease severity (Hoehn and Yahr stage) as opposed to disease duration alone can be demonstrated.
Keywords: Cognition, screening, memory, attention, semantic fluency, severity. References Azuma, T, Cruz, RF, Bayles, KA, Tomoeda, CK, Montgomery, EB, Jr 2003 A longitudinal study of neuropsychological change in individuals with Parkinson’s disease Int J Geriatr Psychiatry 18 1115 1120 PubMed CrossRef Google Scholar Baddeley, A 1992 Working memory Science 255 556 559 PubMed Google Scholar Baddeley, A 2000 The episodic buffer: a new component of working memory? Trends Cogn Sci 4 417 423 PubMed CrossRef Google Scholar Beinhoff, U, Hilbert, V, Bittner, D, Gron, G, Riepe, MW 2005 Screening for cognitive impairment: a triage for outpatient care Dement Geriatr Cogn Disord 20 278 285 PubMed CrossRef Google Scholar Bosboom, JL, Stoffers, D, Wolters, EC 2004 Cognitive dysfunction and dementia in Parkinson’s disease J Neural Transm 111 1303 1315 PubMed CrossRef Google Scholar Breen, EK 1993 Recall and recognition memory in Parkinson’s disease Cortex 29 91 102 PubMed Google Scholar Brown, RG, Marsden, CD 1984 How common is dementia in Parkinson’s disease? Lancet 2 1262 1265 PubMed CrossRef Google Scholar Bublak, P, Muller, U, Gron, G, Reuter, M, von Cramon, DY 2002 Manipulation of working memory information is impaired in Parkinson’s disease and related to working memory capacity Neuropsychology 16 577 590 PubMed CrossRef Google Scholar Buschke, H, Kuslansky, G, Katz, M, Stewart, WF, Sliwinski, MJ, Eckholdt, HM, Lipton, RB 1999 Screening for dementia with the memory impairment screen Neurology 52 231 238 PubMed Google Scholar Desgranges, B, Baron, JC, Eustache, F 1998 The functional neuroanatomy of episodic memory: the role of the frontal lobes, the hippocampal formation, and other areas Neuroimage 8 198 213 PubMed CrossRef Google Scholar Emre, M 2003 What causes mental dysfunction in Parkinson’s disease? Mov Disord 18 S63 S71 PubMed CrossRef Google Scholar Emre, M, Aarsland, D, Albanese, A, Byrne, EJ, Deuschl, G, De Deyn, PP, Durif, F, Kulisevsky, J, van Laar, T, Lees, A, Poewe, W, Robillard, A, Rosa, MM, Wolters, E, Quarg, P, Tekin, S, Lane, R 2004 Rivastigmine for dementia associated with Parkinson’s disease N Engl J Med 351 2509 2518 PubMed CrossRef Google Scholar Erkinjuntti, T, Ostbye, T, Steenhuis, R, Hachinski, V 1997 The effect of different diagnostic criteria on the prevalence of dementia N Engl J Med 337 1667 1674 PubMed CrossRef Google Scholar Goldman, WP, Baty, JD, Buckles, VD, Sahrmann, S, Morris, JC 1998 Cognitive and motor functioning in Parkinson disease: subjects with and without questionable dementia Arch Neurol 55 674 680 PubMed CrossRef Google Scholar Graceffa, AM, Carlesimo, GA, Peppe, A, Caltagirone, C 1999 Verbal working memory deficit in Parkinson’s disease subjects Eur Neurol 42 90 94 PubMed CrossRef Google Scholar Green, J, McDonald, WM, Vitek, JL, Evatt, M, Freeman, A, Haber, M, Bakay, RA, Triche, S, Sirockman, B, DeLong, MR 2002 Cognitive impairments in advanced PD without dementia Neurology 59 1320 1324 PubMed Google Scholar Henry, JD, Crawford, JR 2004 Verbal fluency deficits in Parkinson’s disease: a meta-analysis J Int Neuropsychol Soc 10 608 622 PubMed CrossRef Google Scholar Jacobs, DM, Marder, K, Cote, LJ, Sano, M, Stern, Y, Mayeux, R 1995 Neuropsychological characteristics of preclinical dementia in Parkinson’s disease Neurology 45 1691 1696 PubMed Google Scholar Leopold, NA, Borson, AJ 1997 An alphabetical ‘WORLD’. A new version of an old test Neurology 49 1521 1524 PubMed Google Scholar Levy, G, Jacobs, DM, Tang, MX, Cote, LJ, Louis, ED, Alfaro, B, Mejia, H, Stern, Y, Marder, K 2002 Memory and executive function impairment predict dementia in Parkinson’s disease Mov Disord 17 1221 1226 PubMed CrossRef Google Scholar Lewis, SJ, Dove, A, Robbins, TW, Barker, RA, Owen, AM 2003 Cognitive impairments in early Parkinson’s disease are accompanied by reductions in activity in frontostriatal neural circuitry J Neurosci 23 6351 6356 PubMed Google Scholar Lezak, M 1995Neuropsychological assessment Oxford University Press New York, Oxford Google Scholar Mayeux, R, Stern, Y, Rosenstein, R, Marder, K, Hauser, A, Cote, L, Fahn, S 1988 An estimate of the prevalence of dementia in idiopathic Parkinson’s disease Arch Neurol 45 260 262 PubMed Google Scholar Riepe, MW, Riss, S, Bittner, D, Huber, R 2004 Screening for cognitive impairment in patients with acute stroke Dement Geriatr Cogn Disord 17 49 53 PubMed CrossRef Google Scholar Weintraub, D, Moberg, PJ, Culbertson, WC, Duda, JE, Stern, MB 2004 Evidence for impaired encoding and retrieval memory profiles in Parkinson disease Cogn Behav Neurol 17 195 200 PubMed Google Scholar Werber, EA, Rabey, JM 2001 The beneficial effect of cholinesterase inhibitors on patients suffering from Parkinson’s disease and dementia J Neural Transm 108 1319 1325 PubMed CrossRef Google Scholar Zgaljardic, DJ, Foldi, NS, Borod, JC 2004 Cognitive and behavioral dysfunction in Parkinson’s disease: neurochemical and clinicopathological contributions J Neural Transm 111 1287 1301 PubMed CrossRef Google Scholar