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Cognitive impairment and dementia in Parkinson disease

Epidemiology of dementia associated with Parkinson's disease Point prevalence Incidence Period (cumulative) prevalence Time to dementia in PD Risk factors for dementia in PD Parkinsonism Mild cognitive impairment Visual hallucinations Rapid eye movement sleep behaviour disorder Olfactory dysfunction Cerebrovascular risk factors Genetics Smoking Medications and cholinergic deficits Gender Other factors Conclusions References General features, mode of onset, and course of dementia in Parkinson's disease General features of PD-D Mode and age of onset Mode of onset Age at onset of dementia and time from disease onset to dementia Predictors and early signs Predictors of dementia Early symptoms of incipient dementia Course of dementia and rate of progression Rate of progression Determinants of progression rate Survival Pathological determinants of dementia in PD Conclusion References Cognitive profile in Parkinson's disease dementia Cognitive domains and their assessment Average effect size: a meta-analytic approach Deficits in individual cognitive domains in PD-D Attention and executive functions Attention and bradyphrenia Visuospatial functions Memory Language Conclusion: the overall cognitive profile in PD-D References Neuropsychiatric symptoms in Parkinson's disease dementia Epidemiology Prevalence of neuropsychiatric symptoms Comparison with other disease states Clinical presentation Depression and anxiety Apathy Psychosis Agitation Disorders of sleep and wakefulness Pseudobulbar affect Impulse control disorders Impact of deep brain stimulation Clinical impact Correlates and risk factors Pathophysiology of neuropsychiatric symptoms Assessment and diagnosis Management of neuropsychiatric symptoms Depression and anxiety Apathy Psychosis and agitation Disorders of sleep and wakefulness Pseudobulbar affect Conclusion References Interaction between affect and executive functions in Parkinson's disease Introduction Depression and executive functions in PD Apathy and executive functions in PD Anhedonia and executive functions in PD Conclusion References Motor symptoms and phenotype in patients with Parkinson's disease dementia Motor phenotype in patients with PD-D A data-driven approach to motor phenotype and cognition Expanding the motor phenotype Early cognitive impairment and motor function Motor phenotype as a risk factor for dementia Response to levodopa and motor complications Levodopa-induced motor complications Neuroleptic sensitivity Rate of progression of motor symptoms in PD-D Conclusion References Interaction between cognition and gait in patients with Parkinson's disease Gait disturbances and fall risk Changes in cognition, attention, and executive function Cognitive function and continuous gait changes Freezing of gait and cognitive deficits Conclusion References Disorders of sleep and autonomic function in Parkinson's disease dementia Sleep disturbances in PD-D Insomnia in PD-D REM sleep behaviour disorder Excessive daytime sleepiness Autonomic dysfunction in PD-D Pathophysiology of autonomic symptoms Conclusion References Structural and functional neuroimaging in patients with Parkinson's disease dementia Structural magnetic resonance imaging Diffusion tensor imaging Functional activity imaging Perfusion and metabolism Dopaminergic imaging Cholinergic imaging Amyloid imaging Cardiac scintigraphy imaging Conclusion References Biomarkers for cognitive impairment and dementia in Parkinson's disease Biological heterogeneity The need for biomarkers Cerebrospinal fluid markers a-Synuclein Amyloid-beta Tau Other CSF biomarker candidates Markers of protein degradation Markers of Ap production and clearance Oxidative stress markers Neuroinflammatory markers Markers in other bodily fluids Genetic risk markers Apolipoprotein E (APOE)Microtubule-associated protein tau (MAPT)Glucocerebrosidase (GBA)Cathecol-O-methyltransferase (COMT)Neuroimaging markers Conclusion References Electrophysiological and other auxiliary investigations in patients with Parkinson's disease dementia Electrophysiological methods Electroencephalography (EEG)Evoked potentials Auditory evoked potentials (AEPs)Visual evoked potentials (VEPs)Somatosensory evoked potentials (SEPs)Event-related potentials (ERPs)MIBG myocardial scintigraphy Conclusion References The genetic basis of dementia in Parkinson's disease Finding genes that underlie disease Gene mutations known to cause dominant PD associated with dementia SNCA (previously PARK1, PARK4; encoding the protein a-synuclein)LRRK2 (PARK8; encoding the protein Lrrk2/dardarin)Dementias with parkinsonism Synucleinopathies Tauopathies Genetic risk factors for PD-D APOE GBA Other genetic risk factors for PD-D Next steps in gene identification for dementia in PD Conclusion References Neurochemical pathology of Parkinson's disease dementia and dementia with Lewy bodies Changes in neurotransmitter systems in PD-D Dopamine: pre-synaptic dopaminergic measures Post-synaptic dopaminergic measures Acetylcholine Nicotinic receptor changes Muscarinic receptor changes Relationship between cholinergic medication and Alzheimer-type pathology Glutamate GABA Serotonin (5-hydroxytryptamine, 5-HT)Noradrenaline Calcium Synaptic dysfunction in PD-D Conclusion References Pathological correlates of dementia in Parkinson's disease Lewy body pathology Alzheimer's disease-related pathology Distribution of pathology and clinico-pathological correlation Disease progression Aetiologies underlying neurodegeneration Conclusion References Epidemiology, diagnosis, and correlates of mild cognitive impairment in Parkinson's disease Frequency estimates of PD-MCI Diagnostic criteria for MCI The pattern of cognitive impairment in PD-MCI Genetic and clinical correlates of PD-MCI LRRK2 Parkin GBA APOE, MAPT, COMT Neuroimaging studies of MCI in PD Structural imaging Single-photon emission computed tomography Positron emission tomography (PET)Acetylcholinesterase (AchE) PET imaging Amyloid imaging Cerebrospinal fluid (CSF) biomarkers Conclusion References The pathophysiological and prognostic heterogeneity of mild cognitive impairment in Parkinson's disease Heterogeneity of MCI in PD Prognosis of early cognitive deficits in PD Genetic influences on cognition in PD COMT MAPT APOE GBA Functional imaging Frontostriatal dysfunction Non-dopaminergic networks Conclusion References Spectrum of Lewy body dementias: relationship of Parkinson's disease dementia to dementia with Lewy bodies Comparative neuropathological, neurochemical, and biomarker studies Neuropathology Cerebrospinal fluid (CSF)Neurochemistry Comparative studies of clinical features in PD-D and DLB Cognitive deficits Neuropsychiatric symptoms Parkinsonism Cognitive and functional decline Structural and functional imaging MIBG Magnetic resonance imaging (MRI)SPECT PIB imaging Electrophysiology Genetic studies Treatment response Cholinesterase inhibitors Memantine Antipsychotics Levodopa Clinicopathological dimensions rather than categories: personal interpretation Conclusion References Spectrum of disorders with dementia and parkinsonism Tauopathies and cognition Progressive supranuclear palsy Corticobasal degeneration Frontotemporal dementia with parkinsonism Multiple system atrophy and cognition Conclusion References Diagnosis of dementia in Parkinson's disease Diagnosis of dementia Taking the history Assessment of cognitive functions Composite cognitive scales Neuropsychological tests Assessment of behavioural symptoms Assessment of functional impairment Auxillary methods Diagnostic criteria for PD-D Differential diagnosis Conclusion References Management of Parkinson's disease dementia and dementia with Lewy bodies Making and disclosing the diagnosis Making a problem list, managing antiparkinsonian medications, and non-pharmacological approaches Specific treatments for cognitive impairment Cholinesterase inhibitors Using ChE-Is in practice: predictors of outcome, side effects, and discontinuation N-methyl-D-aspartate (NMDA) antagonists and dopaminergic drugs Drug treatment of psychiatric and behavioural symptoms Conclusion References Parkinson's disease: what will the future bring?Progress towards understanding disease mechanisms From mechanism to treatment References

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Biomarkers for cognitive impairment and dementia in Parkinson's disease
Guido Alves, Kenn Freddy Pedersen, and Jan Petter Larsen Introduction Cognitive impairment is one of the most frequent and disabling non-motor features in Parkinson’s disease (PD). Long-term observational studies indicate that up to 80% of PD patients develop dementia (PD-D) [1, 2]. PD-D...
(Cognitive impairment and dementia in Parkinson disease)
Neuropsychiatric Symptoms in Cognitive Impairment and Dementia: A Brief Introductory Overview
Ana Verdelho and Manuel Gon^alves-Pereira I am myself and my circumstance; and if I do not save it, I do not save myself. Meditations on Quixote Jose Ortega y Gasset, 1914 The Behavioral and Psychological Symptoms of Dementia Neuropsychiatric symptoms in cognitive impairment...
(Neuropsychiatric Symptoms of Cognitive Impairment and Dementia)
General features, mode of onset, and course of dementia in Parkinson's disease
Murat Emre Introduction Dementia associated with Parkinson’s disease (PD-D) demonstrates characteristic features, making it a clinically recognizable entity that is frequently associated with typical pathological changes. These features include its mode of onset, the chronology and course...
(Cognitive impairment and dementia in Parkinson disease)
The genetic basis of dementia in Parkinson's disease
Rita Guerreiro and Andrew Singleton Introduction Parkinson’s disease (PD) is a heterogeneous disease both genetically and clinically. It is hoped that we will eventually be able to dissect out the role of genetics in the clinical heterogeneity of PD. The occurrence of dementia in PD (PD-D)...
(Cognitive impairment and dementia in Parkinson disease)
Pathological correlates of dementia in Parkinson's disease
Gonzalo J. Revuelta, Guttalu K. Kumaraswamy, and Carol F. Lippa Introduction The time-honoured original work by James Parkinson has been shown to be quite insightful in its ability to integrate a constellation of symptoms into a cohesive syndrome by observing a small group of patients....
(Cognitive impairment and dementia in Parkinson disease)
Diagnosis of dementia in Parkinson's disease
Murat Emre Introduction In essence, diagnosis of dementia in a patient with Parkinson’s disease (PD) is no different from diagnosing dementia in any other patient. The diagnostic approach can be conceptualized as a two-step process: diagnosis of dementia and differential diagnosis with...
(Cognitive impairment and dementia in Parkinson disease)
Cognitive impairment and dementias
The Scientific Advisory Committee on Nutrition (2018) examined evidence pertaining to the prevention of cognitive impairment or dementias, including Alzheimer’s disease. The committee recommended a Mediterranean diet. Mental health and wellbeing Advice for keeping mentally well includes •...
(Priorities for Health Promotion and Public Health: Explaining the Evidence for Disease Prevention and Health Promotion)
Cognitive profile in Parkinson's disease dementia
Kolbj0rn Br0nnick Introduction The focus of research in Parkinson’s disease (PD) and Parkinson’s disease dementia (PD-D) has shifted somewhat since the first edition of this book in 2010. There is increased emphasis on mild cognitive impairment (MCI) and how it affects...
(Cognitive impairment and dementia in Parkinson disease)
Epidemiology, diagnosis, and correlates of mild cognitive impairment in Parkinson's disease
Elise Caccappolo and Karen Marder Introduction Earlier work on mild cognitive impairment (MCI) in Parkinson’s disease (PD) was constrained by a lack of standardized diagnostic criteria, and frequently applied established MCI criteria typically used in Alzheimer’s populations [1, 2]....
(Cognitive impairment and dementia in Parkinson disease)
The pathophysiological and prognostic heterogeneity of mild cognitive impairment in Parkinson's disease
Sophie E. Winder-Rhodes, Roger A. Barker, and Caroline H. Williams-Gray Introduction It is now well established that cognitive deficits can occur in Parkinson’s disease (PD) and that some of these develop into dementia. It is also apparent that these deficits vary, not only between patients...
(Cognitive impairment and dementia in Parkinson disease)