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Memory and executive function impairment predict dementia in Parkinson's disease

Authors

  • Gilberto Levy MD,

    1. Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
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  • Diane M. Jacobs PhD,

    1. Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
    2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Ming-Xin Tang PhD,

    1. Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
    2. Division of Biostatistics, School of Public Health, Columbia University, New York, NY, USA
    3. Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, NY, USA
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  • Lucien J. Côté MD,

    1. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Elan D. Louis MD, MS,

    1. Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
    2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Brenda Alfaro MA,

    1. Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
    2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Helen Mejia MA,

    1. Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
    2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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  • Yaakov Stern PhD,

    1. Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
    2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
    3. Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, NY, USA
    4. Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, NY, USA
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  • Karen Marder MD, MPH

    Corresponding author
    1. Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
    2. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
    3. Taub Institute for Research on Alzheimer's Disease and The Aging Brain, Columbia University, New York, NY, USA
    • G.H. Sergievsky Center, 630 West 168th Street, P&S Box 16, New York, NY 10032
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Abstract

We analyzed the association of neuropsychological test impairment at baseline with the development of dementia in idiopathic Parkinson's disease (PD) patients. A cohort of nondemented PD patients from northern Manhattan, NY was followed annually with neurological and neuropsychological evaluations. The neuropsychological battery included tests of verbal and nonverbal memory, orientation, visuospatial ability, language, and abstract reasoning. The association of baseline neuropsychological tests scores with incident dementia was analyzed using Cox proportional hazards models. The analysis controlled for age, gender, education, duration of PD, and the total Unified Parkinson's Disease Rating Scale motor score at baseline. Forty-five out of 164 patients (27%) became demented during a mean follow-up of 3.7 ± 2.3 years. Four neuropsychological test scores were significantly associated with incident dementia in the Cox model: total immediate recall (RR: 0.92, 95% CI: 0.87–0.97, P = 0.001) and delayed recall (RR: 0.73, 95% CI: 0.59–0.91, P = 0.005) of the Selective Reminding Test (SRT), letter fluency (RR: 0.87, 95% CI: 0.77–0.99, P = 0.03), and Identities and Oddities of the Mattis Dementia Rating Scale (RR: 0.85, 95% CI: 0.73–0.98, P = 0.03). When the analysis was performed excluding patients with a clinical dementia rating of 0.5 (questionable dementia) at baseline evaluation, total immediate recall and delayed recall were still predictive of dementia in PD. Our results indicate that impairment in verbal memory and executive function are associated with the development of dementia in patients with PD. © 2002 Movement Disorder Society

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