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Rate of cognitive decline in premotor Parkinson's disease: A prospective study (NEDICES)

Authors

  • Álvaro Sánchez-Ferro MD,

    Corresponding author
    1. Department of Neurology, University Hospital “12 de Octubre,”, Madrid, Spain
    2. Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain
    3. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
    4. Instituto de Salud Carlos III, Madrid, Spain
    • Correspondence to: Álvaro Sánchez-Ferro, C/ La Masó 20, portal 2, piso 2°, ES-28034, Madrid, Spain; alvarosferro@hotmail.com

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  • Julián Benito-León MD, PhD,

    1. Department of Neurology, University Hospital “12 de Octubre,”, Madrid, Spain
    2. Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain
    3. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
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  • Elan D. Louis MD, MSc,

    1. The G.H. Sergievsky Center, College of Physicians and Surgeons, 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, College of Physicians and Surgeons, Columbia University, New York, NY, USA
    4. Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
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  • Alex J. Mitchell MRCPsych,

    1. Department of Psycho-oncology, Leicestershire Partnership Trust and University of Leicester, Leicester, United Kingdom
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  • José Antonio Molina-Arjona MD, PhD,

    1. Department of Neurology, University Hospital “12 de Octubre,”, Madrid, Spain
    2. Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain
    3. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
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  • Rocío Trincado MA,

    1. Department of Neurology, University Hospital “12 de Octubre,”, Madrid, Spain
    2. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
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  • Alberto Villarejo MD, PhD,

    1. Department of Neurology, University Hospital “12 de Octubre,”, Madrid, Spain
    2. Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain
    3. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
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  • Félix Bermejo-Pareja MD, PhD

    1. Department of Neurology, University Hospital “12 de Octubre,”, Madrid, Spain
    2. Department of Medicine, Faculty of Medicine, Complutense University, Madrid, Spain
    3. Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas, Madrid, Spain
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  • Funding agencies: The Spanish Health Research Agency and the Spanish Office of Science and Technology supported NEDICES.

  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

Abstract

Previous research has documented cognitive impairment in the early stages of Parkinson's disease (PD). It is not known when this decline starts or if decline progresses at an accelerated rate during the premotor period of the disorder. In this population-based prospective study of older people (≥65 years) from the Neurological Disorders in Central Spain (NEDICES) cohort, we compared the rates of cognitive decline in 3 groups: (1) non-PD elderly controls; (2) prevalent PD patients (those diagnosed with the disease at baseline, 1994–95); and (3) premotor PD subjects (those diagnosed with the disease at follow up, 1997–98, but not at baseline). A 37-item version of the Mini–Mental State Examination (37-MMSE) was administered in the 2 visits of the study. From 2487 participants (age, 72.8 ± 6.0 years), including 2429 controls, we recruited 21 premotor PD cases, and 37 prevalent PD cases. At baseline, the mean 37-MMSE score was 28.5 ± 4.7 in prevalent cases, 28.1 ± 4.6 in premotor cases, and 29.9 ± 5.0 in controls (P = .046). During the 3-year follow-up period, there was a significant score decline of 2.4 ± 4.6 points in prevalent cases versus 0.2 ± 4.1 points in premotor cases and 0.3 ± 4.0 points in controls (Kruskal–Wallis test, P = .03). In the NEDICES cohort, cognitive test scores of prevalent PD cases declined at a rate above and beyond that observed in premotor PD cases and in controls. The rate of cognitive decline in premotor PD and controls was similar. Our data suggest that a decline in global cognitive function does not occur in premotor PD. © 2012 Movement Disorder Society

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