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Cognitive dysfunction and dementia in Parkinson disease.

Abstract
Impairment in different cognitive domains such as executive functions, language, memory, and visuospatial skills occurs frequently in Parkinson disease (PD) even in the early stages of the disease. Although frank dementia (Parkinson disease dementia, PDD) is less frequent, risk for developing dementia is two to six times greater than the prevalence rate in general population and it increases in relation to disease duration. Clinically, dementia in PD is characterized by uninsidious onset and slowly progressive cognitive decline, with a predominant dysexecutive syndrome accompanied frequently by a variety of behavioral symptoms such as hallucinations, depression, anxiety, and excessive daytime sleepiness. Although the exact pathophysiology and neurobiological basis of PDD is not known, dementia in PD probably develops as a result of progressive involvement of subcortical and cortical structures by Lewy-type pathology and associated Alzheimer-like histological changes. Dysfunction of different monoamine transmitter has also been implicated in the cognitive deterioration of PD but reduced cholinergic activity in the cortex is thought to account for the strongest mechanism in the development of dementia. Recent evidence suggests that cholinesterase inhibitors are effective in the treatment of dementia and accompanying behavioral symptoms in PD.
AuthorsNuria Caballol, Maria J Martí, Eduardo Tolosa
JournalMovement disorders : official journal of the Movement Disorder Society (Mov Disord) Vol. 22 Suppl 17 Pg. S358-66 (Sep 2007) ISSN: 0885-3185 [Print] United States
PMID18175397 (Publication Type: Journal Article, Review)
Topics
  • Anxiety Disorders (epidemiology)
  • Cognition Disorders (diagnosis, epidemiology)
  • Dementia (diagnosis, epidemiology)
  • Depressive Disorder (epidemiology)
  • Diagnostic and Statistical Manual of Mental Disorders
  • Disorders of Excessive Somnolence (epidemiology)
  • Humans
  • Incidence
  • Neuropsychological Tests
  • Parkinson Disease (diagnosis, epidemiology)
  • Prevalence
  • Risk Factors

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