• Open Access

Diagnosis and management of Parkinson’s disease dementia

Authors

  • W. Poewe,

    1. Department of Neurology, Medical University Innsbruck, Innsbruck, Austria
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  • S. Gauthier,

    1. Alzheimer’s Disease Research Unit, McGill Centre for Studies in Aging, Douglas Mental Health University Institute, Montréal, QC, Canada
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  • D. Aarsland,

    1. Norweigen Centre for Movement Disorders, Stavenger University Hospital, Stavenger, Norway
    2. Institute of Clinical Medicine, University of Bergen, Bergen, Norway
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  • J. B. Leverenz,

    1. Mental Illness and Parkinson’s Disease Research Education and Clinical Centers, VA-PSHCS, and Departments of Neurology and Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
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  • P. Barone,

    1. Dipartimento di Scienze Neurologiche, Università Federico II di Napoli, Naples, Italy
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  • D. Weintraub,

    1. Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
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  • E. Tolosa,

    1. Parkinson’s Disease and Movement Disorders Unit, Institut Clínic de Neurociències, and Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Hospital Clínic de Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer, Universitat de Barcelona, Barcelona, Spain
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  • B. Dubois

    1. INSERM-UPMC UMRS 610, Federation of Neurology, Salpêtrière Hospital; University of Paris, Paris, France
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  • Disclosures
    SG has been a consultant and is an investigator in Novartis-sponsored studies, he owns no stock or option; DA has received honoraria and research support from Novartis, Pfizer, Janssen-Cilag, H. Lundbeck, AstraZeneca, he owns no stock or option; JBL has been a consultant for GlaxoSmithKline, and consultant and speaker for Novartis Pharmaceuticals; DW has served as a consultant to Novartis.

  • Re-use of this article is permitted in accordance with the Creative Commons Deed, Attribution 2.5, which does not permit commercial exploitation.

Professor Werner Poewe
Department of Neurology, Medical University Innsbruck, Anichstraße 35, A-6020 Innsbruck, Austria
Tel.: + 43 512 504 23850
Fax: + 43 512 504 23852
Email: werner.poewe@uibk.ac.at

Summary

Parkinson’s disease (PD) has long been considered predominantly a motor disorder. However, its frequent association with dementia, which contributes significantly to the morbidity and mortality of the condition, is gaining increasing recognition. PD dementia (PDD) has a unique clinical profile and neuropathology, distinct from Alzheimer’s disease (AD). Cholinergic deficits, a feature of both AD and PDD, underlie the rationale for cholinesterase inhibitor therapy in both conditions. In clinical practice, it is important that PDD should be recognised and appropriately treated. This review aims to outline the recently proposed clinical diagnostic criteria for PDD and to summarise the guidelines/recommendations published since 2006 on the use of cholinesterase inhibitors in the management of PDD. Although the cholinesterase inhibitor rivastigmine has recently been approved for the management of PDD, there remains a need for the development of novel therapies that can affect key mechanisms of the disease or prevent/delay patients with PD and mild cognitive impairment from progressing to PDD.

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