Clinical and cognitive features associated with psychosis in Parkinson's disease: a longitudinal study.

Autor:	Flanigan JL; Department of Neurology, University of Virginia, Charlottesville, VA, United States., Harrison MB; Department of Neurology, University of Virginia, Charlottesville, VA, United States., Patrie JT; Department of Public Health Sciences, University of Virginia, Charlottesville, VA, United States., Shah BB; Department of Neurology, University of Virginia, Charlottesville, VA, United States., Sperling SA; Center for Neurological Restoration, Department of Neurology, Cleveland Clinic, Cleveland, OH, United States., Wyman-Chick KA; HealthPartners Struthers Parkinson's Center, Saint Paul, MN, United States., Dalrymple WA; Department of Neurology, University of Virginia, Charlottesville, VA, United States., Barrett MJ; Department of Neurology, Virginia Commonwealth University, Richmond, VA, United States.
Jazyk:	angličtina
Zdroj:	Frontiers in aging neuroscience [Front Aging Neurosci] 2024 Nov 06; Vol. 16, pp. 1463426. Date of Electronic Publication: 2024 Nov 06 (Print Publication: 2024).
DOI:	10.3389/fnagi.2024.1463426
Abstrakt:	Background: Parkinson's disease psychosis (PDPsy) is associated with increased nursing home placement and mortality and is closely linked with cognitive dysfunction. Objective: Assess the clinical and cognitive features associated with PDPsy in patients without dementia. Methods: We prospectively recruited people with Parkinson's disease (PwP) without dementia for a 3-year, longitudinal study at an outpatient movement disorders clinic. Participants completed annual visits involving assessment of motor and non-motor symptoms including neuropsychological testing. PDPsy was defined as the recurring presence of visual illusions, sense of presence, hallucinations, or delusions for at least 1 month. Using generalized estimating equations, we conducted two sets of analyses to separately assess the clinical and the cognitive predictors of PDPsy. Results: We enrolled 105 participants. At baseline, mean age was 67.8 (SD = 8.0), median disease duration was 4.9 years (IQR: 3.4-7.7), and mean MoCA was 24.8 (SD = 2.3). Prevalence of PDPsy increased over 3 years from 31% ( n = 32) to 39% ( n = 26). Forty-five participants (43%) experienced PDPsy. Visual illusions were most common (70%, n = 84), followed by hallucinations (58.3%, n = 70). In multivariate analysis, of the clinical variables, only depressive symptoms [OR 1.09, 95% CI: (1.03, 1.16), p = 0.004] increased the odds of PDPsy; of the cognitive variables, only Trail Making Test B-A scores [OR 1.43, 95% CI: (1.06, 1.93), p = 0.018] significantly increased the odds of PDPsy. Conclusions: In PwP without dementia, depressive symptoms were associated with increased risk of PDPsy. Executive/attentional dysfunction was also associated with PDPsy and may mark the transition from isolated minor hallucinations to more complex psychotic symptoms. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Flanigan, Harrison, Patrie, Shah, Sperling, Wyman-Chick, Dalrymple and Barrett.)
Databáze:	MEDLINE
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