The Treatment of Cognitive Impairment Associated with Parkinson's Disease
Version of Record online: 12 APR 2010
© 2010 The Author; Journal Compilation © 2010 International Society of Neuropathology
Volume 20, Issue 3, pages 672–678, May 2010
How to Cite
Burn, D. J. (2010), The Treatment of Cognitive Impairment Associated with Parkinson's Disease. Brain Pathology, 20: 672–678. doi: 10.1111/j.1750-3639.2009.00367.x
- Issue online: 12 APR 2010
- Version of Record online: 12 APR 2010
- Received 11 November 2009; accepted 7 December 2009.
- cholinesterase inhibitor;
- cognitive impairment;
- Parkinson's disease;
Cognitive impairment and dementia associated with Parkinson's disease (PD) are common and often have devastating effects upon the patient and their family. Early cognitive impairment in PD is frequent, and the functional impact may be underestimated. Optimal management will rely upon better identification of the predominant symptoms and greater knowledge of their pathophysiological basis. The management of dementia in PD (PD-D) also has to consider the significant neuropsychiatric burden that frequently accompanies the cognitive decline, as well as fluctuations in attention. Atypical anti-psychotics have a limited role at present in treating PD-D, although new drugs are under development. The mainstay of drug management for people with PD-D is cholinesterase inhibitors, although recent trials have suggested that the N-methyl-D aspartate antagonist memantine may also have some benefit. Disease modification remains the ultimate goal for preventing the inexorable decline in PD-D, although effective interventions are still some way off. Limited benefit may, however, be possible through exercise programmes and so-called “medical foods”, although randomised trials are required to confirm largely anecdotal observations.