Movement Disorders (revue)

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Association Between Cognition and Function in Patients With Parkinson Disease With and Without Dementia

Identifieur interne : 000365 ( Pmc/Checkpoint ); précédent : 000364; suivant : 000366

Association Between Cognition and Function in Patients With Parkinson Disease With and Without Dementia

Auteurs : Emily Rosenthal [États-Unis] ; Laura Brennan [États-Unis] ; Sharon Xie [États-Unis] ; Howard Hurtig [États-Unis] ; Joshua Milber [États-Unis] ; Daniel Weintraub [États-Unis] ; Jason Karlawish [États-Unis] ; Andrew Siderowf [États-Unis]

Source :

RBID : PMC:2963089

Abstract

Patients with Parkinson's disease (PD) often have cognitive deficits from the time of diagnosis. Except in patients with dementia, the impact of cognitive symptoms on daily function is not well documented. This study had two objectives: (1) to determine the functional significance of cognitive deficits in nondemented patients with PD and (2) to assess the sensitivity of two measures of global cognitive abilities to identify individuals with impaired ADL function. One hundred eleven subjects with PD and a range of cognitive abilities were included. Of these, 20 were diagnosed with PDD. All subjects were assessed with the Mattis Dementia Rating Scale to two (DRS-2) and the Mini-Mental State Examination (MMSE). ADL function was reported by an informant using the Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL). The ability of the DRS-2 and MMSE to capture the impact of cognitive impairment on ADL function was assessed in the entire cohort and in subsets of nondemented individuals. After adjustment for covariates, cognition as measured by the DRS-2 was strongly related to ADL function in the entire cohort (partial correlation coefficient = 0.55, P < 0.001). The association remained strong when only nondemented subjects were included (r = 0.42, P < 0.001). The DRS-2 was significantly more accurate than the MMSE, particularly for detecting milder degrees of ADL impairment (ROC area = 0.87 vs. 0.75, P = 0.0008). Cognition is associated with impairment in ADL function, even in nondemented patients with PD. However, sensitive cognitive assessment measures may be needed to identify these functionally relevant impairments.


Url:
DOI: 10.1002/mds.23073
PubMed: 20310053
PubMed Central: 2963089


Affiliations:


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PMC:2963089

Le document en format XML

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<p id="P1">Patients with Parkinson's disease (PD) often have cognitive deficits from the time of diagnosis. Except in patients with dementia, the impact of cognitive symptoms on daily function is not well documented. This study had two objectives: (1) to determine the functional significance of cognitive deficits in nondemented patients with PD and (2) to assess the sensitivity of two measures of global cognitive abilities to identify individuals with impaired ADL function. One hundred eleven subjects with PD and a range of cognitive abilities were included. Of these, 20 were diagnosed with PDD. All subjects were assessed with the Mattis Dementia Rating Scale to two (DRS-2) and the Mini-Mental State Examination (MMSE). ADL function was reported by an informant using the Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL). The ability of the DRS-2 and MMSE to capture the impact of cognitive impairment on ADL function was assessed in the entire cohort and in subsets of nondemented individuals. After adjustment for covariates, cognition as measured by the DRS-2 was strongly related to ADL function in the entire cohort (partial correlation coefficient = 0.55,
<italic>P</italic>
< 0.001). The association remained strong when only nondemented subjects were included (
<italic>r</italic>
= 0.42,
<italic>P</italic>
< 0.001). The DRS-2 was significantly more accurate than the MMSE, particularly for detecting milder degrees of ADL impairment (ROC area = 0.87 vs. 0.75,
<italic>P</italic>
= 0.0008). Cognition is associated with impairment in ADL function, even in nondemented patients with PD. However, sensitive cognitive assessment measures may be needed to identify these functionally relevant impairments.</p>
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<article-title>Association Between Cognition and Function in Patients With Parkinson Disease With and Without Dementia</article-title>
</title-group>
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<contrib contrib-type="author">
<name>
<surname>Rosenthal</surname>
<given-names>Emily</given-names>
</name>
<degrees>BA</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Brennan</surname>
<given-names>Laura</given-names>
</name>
<degrees>BA</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Xie</surname>
<given-names>Sharon</given-names>
</name>
<degrees>PhD</degrees>
<xref ref-type="aff" rid="A2">2</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Hurtig</surname>
<given-names>Howard</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Milber</surname>
<given-names>Joshua</given-names>
</name>
<xref ref-type="aff" rid="A1">1</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Weintraub</surname>
<given-names>Daniel</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A3">3</xref>
<xref ref-type="aff" rid="A4">4</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Karlawish</surname>
<given-names>Jason</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="A5">5</xref>
</contrib>
<contrib contrib-type="author">
<name>
<surname>Siderowf</surname>
<given-names>Andrew</given-names>
</name>
<degrees>MD, MSCE</degrees>
<xref ref-type="aff" rid="A1">1</xref>
<xref ref-type="corresp" rid="CR1">*</xref>
</contrib>
</contrib-group>
<aff id="A1">
<label>1</label>
Department of Neurology, Division of Geriatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA</aff>
<aff id="A2">
<label>2</label>
Department of Biostatistics, Division of Geriatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA</aff>
<aff id="A3">
<label>3</label>
Department of Psychiatry, Division of Geriatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA</aff>
<aff id="A4">
<label>4</label>
Philadelphia Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA</aff>
<aff id="A5">
<label>5</label>
Department of Medicine and Medical Ethics, Division of Geriatrics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA</aff>
<author-notes>
<corresp id="CR1">
<label>*</label>
Correspondence to: Andrew Siderowf, Department of Neurology, 330 South 9th Street, Second Floor, Philadelphia, PA 19107.
<email>andrew.siderowf@uphs.upenn.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="nihms-submitted">
<day>4</day>
<month>10</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="ppub">
<day>15</day>
<month>7</month>
<year>2010</year>
</pub-date>
<pub-date pub-type="pmc-release">
<day>25</day>
<month>10</month>
<year>2010</year>
</pub-date>
<volume>25</volume>
<issue>9</issue>
<fpage>1170</fpage>
<lpage>1176</lpage>
<permissions>
<copyright-statement>© 2010 Movement Disorder Society</copyright-statement>
<copyright-year>2010</copyright-year>
</permissions>
<abstract>
<p id="P1">Patients with Parkinson's disease (PD) often have cognitive deficits from the time of diagnosis. Except in patients with dementia, the impact of cognitive symptoms on daily function is not well documented. This study had two objectives: (1) to determine the functional significance of cognitive deficits in nondemented patients with PD and (2) to assess the sensitivity of two measures of global cognitive abilities to identify individuals with impaired ADL function. One hundred eleven subjects with PD and a range of cognitive abilities were included. Of these, 20 were diagnosed with PDD. All subjects were assessed with the Mattis Dementia Rating Scale to two (DRS-2) and the Mini-Mental State Examination (MMSE). ADL function was reported by an informant using the Alzheimer's Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL). The ability of the DRS-2 and MMSE to capture the impact of cognitive impairment on ADL function was assessed in the entire cohort and in subsets of nondemented individuals. After adjustment for covariates, cognition as measured by the DRS-2 was strongly related to ADL function in the entire cohort (partial correlation coefficient = 0.55,
<italic>P</italic>
< 0.001). The association remained strong when only nondemented subjects were included (
<italic>r</italic>
= 0.42,
<italic>P</italic>
< 0.001). The DRS-2 was significantly more accurate than the MMSE, particularly for detecting milder degrees of ADL impairment (ROC area = 0.87 vs. 0.75,
<italic>P</italic>
= 0.0008). Cognition is associated with impairment in ADL function, even in nondemented patients with PD. However, sensitive cognitive assessment measures may be needed to identify these functionally relevant impairments.</p>
</abstract>
<kwd-group>
<kwd>Parkinson's disease</kwd>
<kwd>cognitive impairment</kwd>
<kwd>ADL</kwd>
</kwd-group>
<contract-num rid="NS1">P50 NS053488-030001 ||NS</contract-num>
<contract-num rid="NS1">P50 NS053488-020001 ||NS</contract-num>
<contract-num rid="NS1">P50 NS053488-01A20001 ||NS</contract-num>
<contract-sponsor id="NS1">National Institute of Neurological Disorders and Stroke : NINDS</contract-sponsor>
</article-meta>
</front>
</pmc>
<affiliations>
<list>
<country>
<li>États-Unis</li>
</country>
<region>
<li>Pennsylvanie</li>
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<region name="Pennsylvanie">
<name sortKey="Rosenthal, Emily" sort="Rosenthal, Emily" uniqKey="Rosenthal E" first="Emily" last="Rosenthal">Emily Rosenthal</name>
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<name sortKey="Brennan, Laura" sort="Brennan, Laura" uniqKey="Brennan L" first="Laura" last="Brennan">Laura Brennan</name>
<name sortKey="Hurtig, Howard" sort="Hurtig, Howard" uniqKey="Hurtig H" first="Howard" last="Hurtig">Howard Hurtig</name>
<name sortKey="Karlawish, Jason" sort="Karlawish, Jason" uniqKey="Karlawish J" first="Jason" last="Karlawish">Jason Karlawish</name>
<name sortKey="Milber, Joshua" sort="Milber, Joshua" uniqKey="Milber J" first="Joshua" last="Milber">Joshua Milber</name>
<name sortKey="Siderowf, Andrew" sort="Siderowf, Andrew" uniqKey="Siderowf A" first="Andrew" last="Siderowf">Andrew Siderowf</name>
<name sortKey="Weintraub, Daniel" sort="Weintraub, Daniel" uniqKey="Weintraub D" first="Daniel" last="Weintraub">Daniel Weintraub</name>
<name sortKey="Weintraub, Daniel" sort="Weintraub, Daniel" uniqKey="Weintraub D" first="Daniel" last="Weintraub">Daniel Weintraub</name>
<name sortKey="Xie, Sharon" sort="Xie, Sharon" uniqKey="Xie S" first="Sharon" last="Xie">Sharon Xie</name>
</country>
</tree>
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}}

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HfdIndexSelect -h $EXPLOR_AREA/Data/Pmc/Checkpoint/RBID.i   -Sk "pubmed:20310053" \
       | HfdSelect -Kh $EXPLOR_AREA/Data/Pmc/Checkpoint/biblio.hfd   \
       | NlmPubMed2Wicri -a MovDisordV3 

Wicri

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Data generation: Sun Jul 3 12:29:32 2016. Site generation: Wed Feb 14 10:52:30 2024