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From the Section of Geriatric Psychiatry (Dr. Aarsland), Rogaland Psychiatric Hospital, and the Department of Neurology (Dr. Larsen), Central Hospital of Rogaland, Stavanger, Norway; and the Departments of Psychiatry (Drs. Andersen, Lolk, and Kragh-Sørensen) and Neurology (Dr. Nielsen), Odense University Hospital, Odense, Denmark.
Address correspondence and reprint requests to Dr. Dag Aarsland, Section of Geriatric Psychiatry, Rogaland Psychiatric Hospital, PO Box 1163 Hillevåg, N-4095 Stavanger, Norway; e-mail: aarsland{at}netpower.no
OBJECTIVE: To calculate the incidence of and determine possible risk factors for dementia in PD.
BACKGROUND: Dementia has important clinical consequences for patients with PD and their caregivers, but the incidence is unknown.
METHODS: A population-based cohort of nondemented patients with PD (n = 171) from the county of Rogaland, Norway, was assessed at baseline and 4.2 years later with a comprehensive evaluation of motor, cognitive, and neuropsychiatric symptoms. The diagnosis of dementia was made according to the Diagnostic and Statistical Manual of Mental Disorders, 3rd edition, revised (DSM-III-R) criteria, based on interview of the patient and a caregiver, cognitive rating scales, and neuropsychologic tests. A representative sample of 3,062 nondemented elderly subjects without PD served as control group.
RESULTS: Forty-three patients with PD were demented at follow-up evaluation, equivalent to an incidence rate of 95.3 per 1,000 person-years (95% CI, 68.2 to 122.0). The risk for the development of dementia in patients with PD relative to the control subjects after adjusting for age, sex, and education was 5.9 (95% CI, 3.9 to 9.1). Predictive factors at baseline for dementia in PD in addition to age were Hoehn & Yahr score >2 (OR, 3.4; 95% CI, 1.3 to 8.6) and Mini-Mental State Examination score <29 (OR, 3.3; 95% CI, 1.3 to 8.2).
CONCLUSIONS: Patients with PD have an almost sixfold increased risk for becoming demented compared with subjects without PD.
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