Predictors of dementia in Parkinson disease: A prospective cohort study
| Autor: | Silvia Rios Romenets, Jacques Montplaisir, Michel Panisset, Véronique Latreille, Josie-Anne Bertrand, Jean-François Gagnon, Julius B. M. Anang, Ronald B. Postuma |
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| Jazyk: | angličtina |
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Blood Pressure Color Vision Defects REM Sleep Behavior Disorder Disease Logistic regression REM sleep behavior disorder Article Sex Factors Risk Factors Internal medicine mental disorders medicine Humans Purdue Pegboard Test Dementia Cognitive Dysfunction Prospective Studies Prospective cohort study Gait Aged Age Factors Parkinson Disease Odds ratio Middle Aged medicine.disease Logistic Models Blood pressure Physical therapy Female Neurology (clinical) Psychology Follow-Up Studies |
| Popis: | We investigated an array of possible markers of early dementia in Parkinson disease.We performed a comprehensive assessment of autonomic, sleep, psychiatric, visual, olfactory, and motor manifestations in 80 patients with Parkinson disease who were dementia-free at baseline. After 4.4 years' follow-up, patients were evaluated for dementia. Predictive variables were assessed using logistic regression adjusting for disease duration, follow-up duration, age, and sex.Of 80 patients, 27 (34%) developed dementia. Patients destined to develop dementia were older and more often male (odds ratio [OR] = 3.64, p = 0.023). Those with baseline mild cognitive impairment had increased dementia risk (OR = 22.5, p0.001). REM sleep behavior disorder at baseline dramatically increased dementia risk (OR = 49.7, p = 0.001); however, neither daytime sleepiness nor insomnia predicted dementia. Higher baseline blood pressure increased dementia risk (OR = 1.37 per 10 mm Hg, p = 0.032). Orthostatic blood pressure drop was strongly associated with dementia risk (OR = 1.84 per 10 mm Hg, p0.001); having a systolic drop of10 mm Hg increased dementia odds 7-fold (OR = 7.3, p = 0.002). Abnormal color vision increased dementia risk (OR = 3.3, p = 0.014), but olfactory dysfunction did not. Among baseline motor variables, proportion of gait involvement (OR = 1.12, p = 0.023), falls (OR = 3.02, p = 0.042), and freezing (OR = 2.63, p = 0.013), as well as the Purdue Pegboard Test (OR = 0.67, p = 0.049) and alternate tap test (OR = 0.97, p = 0.033) predicted dementia.Cardiovascular autonomic dysfunction, REM sleep behavior disorder, color discrimination ability, and gait dysfunction strongly predict development of dementia in Parkinson disease. |
| Databáze: | OpenAIRE |
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