People with Parkinson Disease and Normal MMSE Score Have a Broad Range of Cognitive Performance
Identifieur interne : 004065 ( Ncbi/Curation ); précédent : 004064; suivant : 004066People with Parkinson Disease and Normal MMSE Score Have a Broad Range of Cognitive Performance
Auteurs : Dj Burdick [États-Unis] ; B. Cholerton [États-Unis] ; Gs Watson [États-Unis] ; A. Siderowf ; Jq Trojanowski [États-Unis] ; D. Weintraub [États-Unis] ; B. Ritz [États-Unis] ; Sl Rhodes [États-Unis] ; R. Rausch [États-Unis] ; Sa Factor [États-Unis] ; C. Wood-Siverio [États-Unis] ; Jf Quinn [États-Unis] ; Ka Chung [États-Unis] ; S. Srivatsal [États-Unis] ; Kl Edwards [États-Unis] ; Tj Montine [États-Unis] ; Cp Zabetian [États-Unis] ; Jb LeverenzSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2014.
English descriptors
- KwdEn :
- MESH :
- complications : Parkinson Disease.
- diagnosis : Cognition Disorders.
- etiology : Cognition Disorders.
- Adult, Aged, Aged, 80 and over, Cross-Sectional Studies, Executive Function, Female, Humans, Male, Memory, Mental Status Schedule, Middle Aged, Neuropsychological Tests, Observation, Verbal Learning.
Abstract
Cognitive impairment, including dementia, is common in Parkinson disease (PD). The Mini-Mental State Examination (MMSE) has been recommended as a screening tool for PDD, with values below 26 indicative of possible dementia. Using a detailed neuropsychological battery, we examined the range of cognitive impairment in PD patients with a MMSE score ≥ 26.
In this multi-center, cross-sectional, observational study, we performed neuropsychological testing in a sample of 788 PD patients with MMSE ≥ 26. Evaluation included tests of global cognition, executive function, language, memory, and visuospatial skills. A consensus panel reviewed results for 342 subjects and assigned a diagnosis of no cognitive impairment, mild cognitive impairment, or dementia.
67% of the 788 subjects performed 1.5 standard deviations below the normative mean on at least one test. On eight of the 15 tests, more than 20% of subjects scored 1.5 standard deviations or more below the normative mean. Greatest impairments were found on Hopkins Verbal Learning and Digit Symbol Coding tests. The sensitivity of the MMSE to detect dementia was 45% in a subset of participants who underwent clinical diagnostic procedures.
A remarkably wide range of cognitive impairment can be found in PD patients with a relatively high score on the MMSE, including a level of cognitive impairment consistent with dementia. Given these findings, clinicians must be aware of the limitations of the MMSE in detecting cognitive impairment, including dementia, in PD.
Url:
DOI: 10.1002/mds.25924
PubMed: 25073717
PubMed Central: 4162839
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A. Siderowf<affiliation><nlm:aff id="A18">Avid Radiopharmaceuticals, Philadelphia, PN</nlm:aff>
<wicri:noCountry code="subfield">PN</wicri:noCountry>
</affiliation>
<affiliation><nlm:aff id="A19">Lou Ruvo Center for Brain Health, Cleveland Clinic Foundation, Cleveland OH</nlm:aff>
<wicri:noCountry code="subfield">Cleveland OH</wicri:noCountry>
</affiliation>
Le document en format XML
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<author><name sortKey="Chung, Ka" sort="Chung, Ka" uniqKey="Chung K" first="Ka" last="Chung">Ka Chung</name>
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<author><name sortKey="Srivatsal, S" sort="Srivatsal, S" uniqKey="Srivatsal S" first="S" last="Srivatsal">S. Srivatsal</name>
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<author><name sortKey="Edwards, Kl" sort="Edwards, Kl" uniqKey="Edwards K" first="Kl" last="Edwards">Kl Edwards</name>
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<author><name sortKey="Montine, Tj" sort="Montine, Tj" uniqKey="Montine T" first="Tj" last="Montine">Tj Montine</name>
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<wicri:cityArea>Department of Neurology, University of Washington, Seattle</wicri:cityArea>
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<author><name sortKey="Leverenz, Jb" sort="Leverenz, Jb" uniqKey="Leverenz J" first="Jb" last="Leverenz">Jb Leverenz</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">People with Parkinson Disease and Normal MMSE Score Have a Broad Range of Cognitive Performance</title>
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<author><name sortKey="Cholerton, B" sort="Cholerton, B" uniqKey="Cholerton B" first="B" last="Cholerton">B. Cholerton</name>
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<affiliation wicri:level="2"><nlm:aff id="A7">Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA</nlm:aff>
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<author><name sortKey="Siderowf, A" sort="Siderowf, A" uniqKey="Siderowf A" first="A" last="Siderowf">A. Siderowf</name>
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<author><name sortKey="Trojanowski, Jq" sort="Trojanowski, Jq" uniqKey="Trojanowski J" first="Jq" last="Trojanowski">Jq Trojanowski</name>
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</placeName>
<wicri:cityArea>Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia</wicri:cityArea>
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<author><name sortKey="Weintraub, D" sort="Weintraub, D" uniqKey="Weintraub D" first="D" last="Weintraub">D. Weintraub</name>
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<affiliation wicri:level="2"><nlm:aff id="A11">Department of Psychiatry, University of Pennsylvania, Philadelphia, PA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Pennsylvanie</region>
</placeName>
<wicri:cityArea>Department of Psychiatry, University of Pennsylvania, Philadelphia</wicri:cityArea>
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<author><name sortKey="Ritz, B" sort="Ritz, B" uniqKey="Ritz B" first="B" last="Ritz">B. Ritz</name>
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<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Epidemiology, University of California Los Angeles, Los Angeles</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A14">Department of Neurology, University of California Los Angeles, Los Angeles, CA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Neurology, University of California Los Angeles, Los Angeles</wicri:cityArea>
</affiliation>
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<author><name sortKey="Rhodes, Sl" sort="Rhodes, Sl" uniqKey="Rhodes S" first="Sl" last="Rhodes">Sl Rhodes</name>
<affiliation wicri:level="2"><nlm:aff id="A13">Department of Epidemiology, University of California Los Angeles, Los Angeles, CA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Epidemiology, University of California Los Angeles, Los Angeles</wicri:cityArea>
</affiliation>
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<author><name sortKey="Rausch, R" sort="Rausch, R" uniqKey="Rausch R" first="R" last="Rausch">R. Rausch</name>
<affiliation wicri:level="2"><nlm:aff id="A14">Department of Neurology, University of California Los Angeles, Los Angeles, CA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Neurology, University of California Los Angeles, Los Angeles</wicri:cityArea>
</affiliation>
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<author><name sortKey="Factor, Sa" sort="Factor, Sa" uniqKey="Factor S" first="Sa" last="Factor">Sa Factor</name>
<affiliation wicri:level="2"><nlm:aff id="A15">Department of Neurology, Emory University, Atlanta, GA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Department of Neurology, Emory University, Atlanta</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Wood Siverio, C" sort="Wood Siverio, C" uniqKey="Wood Siverio C" first="C" last="Wood-Siverio">C. Wood-Siverio</name>
<affiliation wicri:level="2"><nlm:aff id="A15">Department of Neurology, Emory University, Atlanta, GA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Géorgie (États-Unis)</region>
</placeName>
<wicri:cityArea>Department of Neurology, Emory University, Atlanta</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Quinn, Jf" sort="Quinn, Jf" uniqKey="Quinn J" first="Jf" last="Quinn">Jf Quinn</name>
<affiliation wicri:level="2"><nlm:aff id="A16">Portland VA Medical Center, Parkinson’s Disease Research Education and Clinical Center, Portland, OR</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Oregon</region>
</placeName>
<wicri:cityArea>Portland VA Medical Center, Parkinson’s Disease Research Education and Clinical Center, Portland</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A17">Department of Neurology, Oregon Health & Science University, Portland, OR</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Oregon</region>
</placeName>
<wicri:cityArea>Department of Neurology, Oregon Health & Science University, Portland</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Chung, Ka" sort="Chung, Ka" uniqKey="Chung K" first="Ka" last="Chung">Ka Chung</name>
<affiliation wicri:level="2"><nlm:aff id="A16">Portland VA Medical Center, Parkinson’s Disease Research Education and Clinical Center, Portland, OR</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Oregon</region>
</placeName>
<wicri:cityArea>Portland VA Medical Center, Parkinson’s Disease Research Education and Clinical Center, Portland</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A17">Department of Neurology, Oregon Health & Science University, Portland, OR</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Oregon</region>
</placeName>
<wicri:cityArea>Department of Neurology, Oregon Health & Science University, Portland</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Srivatsal, S" sort="Srivatsal, S" uniqKey="Srivatsal S" first="S" last="Srivatsal">S. Srivatsal</name>
<affiliation wicri:level="2"><nlm:aff id="A3">VA Puget Sound Health Care System, Parkinson’s Disease, Research Education and Clinical Center, University of Washington, Seattle, WA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>VA Puget Sound Health Care System, Parkinson’s Disease, Research Education and Clinical Center, University of Washington, Seattle</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A5">Department of Neurology, University of Washington, Seattle, WA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Department of Neurology, University of Washington, Seattle</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Edwards, Kl" sort="Edwards, Kl" uniqKey="Edwards K" first="Kl" last="Edwards">Kl Edwards</name>
<affiliation wicri:level="2"><nlm:aff id="A4">Department of Epidemiology, University of Washington, Seattle, WA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Department of Epidemiology, University of Washington, Seattle</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Montine, Tj" sort="Montine, Tj" uniqKey="Montine T" first="Tj" last="Montine">Tj Montine</name>
<affiliation wicri:level="2"><nlm:aff id="A6">Department of Pathology, University of Washington, Seattle, WA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Department of Pathology, University of Washington, Seattle</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Zabetian, Cp" sort="Zabetian, Cp" uniqKey="Zabetian C" first="Cp" last="Zabetian">Cp Zabetian</name>
<affiliation wicri:level="2"><nlm:aff id="A1">VA Puget Sound Health Care System, Geriatric, Research Education and Clinical Center, University of Washington, Seattle, WA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>VA Puget Sound Health Care System, Geriatric, Research Education and Clinical Center, University of Washington, Seattle</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A3">VA Puget Sound Health Care System, Parkinson’s Disease, Research Education and Clinical Center, University of Washington, Seattle, WA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>VA Puget Sound Health Care System, Parkinson’s Disease, Research Education and Clinical Center, University of Washington, Seattle</wicri:cityArea>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="A5">Department of Neurology, University of Washington, Seattle, WA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<placeName><region type="state">Washington (État)</region>
</placeName>
<wicri:cityArea>Department of Neurology, University of Washington, Seattle</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Leverenz, Jb" sort="Leverenz, Jb" uniqKey="Leverenz J" first="Jb" last="Leverenz">Jb Leverenz</name>
<affiliation><nlm:aff id="A19">Lou Ruvo Center for Brain Health, Cleveland Clinic Foundation, Cleveland OH</nlm:aff>
<wicri:noCountry code="subfield">Cleveland OH</wicri:noCountry>
</affiliation>
</author>
</analytic>
<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
<idno type="ISSN">0885-3185</idno>
<idno type="eISSN">1531-8257</idno>
<imprint><date when="2014">2014</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cognition Disorders (diagnosis)</term>
<term>Cognition Disorders (etiology)</term>
<term>Cross-Sectional Studies</term>
<term>Executive Function</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Memory</term>
<term>Mental Status Schedule</term>
<term>Middle Aged</term>
<term>Neuropsychological Tests</term>
<term>Observation</term>
<term>Parkinson Disease (complications)</term>
<term>Verbal Learning</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Cognition Disorders</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Cognition Disorders</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Cross-Sectional Studies</term>
<term>Executive Function</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Memory</term>
<term>Mental Status Schedule</term>
<term>Middle Aged</term>
<term>Neuropsychological Tests</term>
<term>Observation</term>
<term>Verbal Learning</term>
</keywords>
</textClass>
</profileDesc>
</teiHeader>
<front><div type="abstract" xml:lang="en"><sec id="S1"><title>Background</title>
<p id="P1">Cognitive impairment, including dementia, is common in Parkinson disease (PD). The Mini-Mental State Examination (MMSE) has been recommended as a screening tool for PDD, with values below 26 indicative of possible dementia. Using a detailed neuropsychological battery, we examined the range of cognitive impairment in PD patients with a MMSE score ≥ 26.</p>
</sec>
<sec id="S2"><title>Methods</title>
<p id="P2">In this multi-center, cross-sectional, observational study, we performed neuropsychological testing in a sample of 788 PD patients with MMSE ≥ 26. Evaluation included tests of global cognition, executive function, language, memory, and visuospatial skills. A consensus panel reviewed results for 342 subjects and assigned a diagnosis of no cognitive impairment, mild cognitive impairment, or dementia.</p>
</sec>
<sec id="S3"><title>Results</title>
<p id="P3">67% of the 788 subjects performed 1.5 standard deviations below the normative mean on at least one test. On eight of the 15 tests, more than 20% of subjects scored 1.5 standard deviations or more below the normative mean. Greatest impairments were found on Hopkins Verbal Learning and Digit Symbol Coding tests. The sensitivity of the MMSE to detect dementia was 45% in a subset of participants who underwent clinical diagnostic procedures.</p>
</sec>
<sec id="S4"><title>Conclusions</title>
<p id="P4">A remarkably wide range of cognitive impairment can be found in PD patients with a relatively high score on the MMSE, including a level of cognitive impairment consistent with dementia. Given these findings, clinicians must be aware of the limitations of the MMSE in detecting cognitive impairment, including dementia, in PD.</p>
</sec>
</div>
</front>
</TEI>
</record>
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