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Cognitive profile of patients with newly diagnosed Parkinson disease

Dino Muslimovi, MSc, Bart Post, MD, Johannes D. Speelman, MD, PhD and Ben Schmand, PhD

From the Department of Neurology, Academic Medical Center, University of Amsterdam, the Netherlands; and CARPA Study Group (Drs. Post and Speelman).

address correspondence and reprint requests to Dr. D. Muslimovic, AMC Neurology, H2-222, P.O. Box 22660, 1100 DD Amsterdam, the Netherlands; e-mail: d.muslimovic{at}amc.uva.nl

Objective: To determine the frequency and pattern of cognitive dysfunction in patients with newly diagnosed Parkinson disease (PD) and to identify its demographic and clinical correlates.

Methods: A cohort of 115 consecutive patients with newly diagnosed PD and 70 healthy controls underwent a comprehensive neuropsychological assessment including tests of psychomotor speed, attention, language, memory, executive and visuospatial functions, as well as measures of affective status. Patients also received quantitative ratings of motor symptom severity and functional status. Neuropsychological performance of PD patients was compared with that of healthy controls and with available normative data. Independent demographic and clinical predictors of cognitive impairment were identified with multiple logistic regression analysis.

Results: Relative to controls, PD patients performed significantly worse on most cognitive measures. However, further analysis revealed that group differences in cognitive performance could mainly be explained by measures of immediate memory and executive function. Comparison with normative data showed that impairments were most frequent on measures of executive function, memory and psychomotor speed. In all, 24% of PD patients (4% of controls) displayed defective performance on at least three neuropsychological tests and were classified as cognitively impaired. Late onset of disease was an independent predictor of cognitive dysfunction in PD.

Conclusion: Cognitive impairments are common even in newly diagnosed Parkinson disease patients, with deficits being most prominent in the domains of memory and executive functions. Older age at disease onset is likely to be an important determinant of cognitive dysfunction in Parkinson disease.

Additional material related to this article can be found on the Neurology Web site. Go to www.neurology.org and scroll down the Table of Contents for the October 25 issue to find the link for this article.

Supported by the Prinses Beatrix Fonds (Grant PGO 01-0138 to B. Schmand).

Disclosure: The authors report no conflicts of interest.

Received April 27, 2005. Accepted in final form July 11, 2005.

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