School of Medicine and Health Sciences Poster Presentations
Prevalence of MCI and Dementia in Parkinson's Disease
Poster Number
286
Document Type
Poster
Status
Medical Student
Abstract Category
Neuroscience
Keywords
MCI, PDD, Parkinson's disease
Publication Date
Spring 2018
Abstract
Background Although Parkinson’s disease (PD) was traditionally defined by its motor symptoms, cognitive impairment has increasingly been considered as part of the disease process. Although one third of patients will have mild cognitive dysfunction at initial presentation, studies have postulated that over 80% of patients will continue to develop dementia. We aimed to assess the prevalence of both MCI and dementia in participants who were deemed to have PD on autopsy. Methods One of the goals of the Johns Hopkins Morris K. Udall Parkinson’s Disease Research Center autopsy study is to examine the relationship between the clinical symptoms of PD and the disease process in autopsy brain tissue. We analyzed cognitive testing, depression and anxiety scales, caregiver burden scales, and the most recent medical records prior to death to assess whether each participant had normal cognition, MCI, or dementia based on the Movement Disorder Society (MDS) Task Force guidelines for diagnostic criteria for PD-MCI and PDD. Results There were 174 participants with an average of 77.1 years old at the time of autopsy, 31.6% of whom were women. Participants completed an average of 15.99 years of education and suffered from PD for an average of 15.86 years. Depression was present in 41 participants (23.56%). Dementia was diagnosed in 129 participants (74.13%), whereas 18 participants had normal cognition (10.34%). MCI accounted for 14 participants (8.04%). Another 4 participants were postulated to have MCI based on the records we analyzed, however due to missing data they did not meet the strict criteria. In total, 13 (7.04%) of the participants had insufficient data to use the MDS diagnostic criteria to determine their cognitive status. Discussion The majority of participants developed PDD at some point in their disease course. However, there were a subset of patients with similar disease duration who had MCI that did not progress to PDD. Further investigation should be done to explore the cognitive domains affected by MCI and dementia to determine whether MCI is a separate disease entity or part of the spectrum of neurocognitive disorder.
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Prevalence of MCI and Dementia in Parkinson's Disease
Background Although Parkinson’s disease (PD) was traditionally defined by its motor symptoms, cognitive impairment has increasingly been considered as part of the disease process. Although one third of patients will have mild cognitive dysfunction at initial presentation, studies have postulated that over 80% of patients will continue to develop dementia. We aimed to assess the prevalence of both MCI and dementia in participants who were deemed to have PD on autopsy. Methods One of the goals of the Johns Hopkins Morris K. Udall Parkinson’s Disease Research Center autopsy study is to examine the relationship between the clinical symptoms of PD and the disease process in autopsy brain tissue. We analyzed cognitive testing, depression and anxiety scales, caregiver burden scales, and the most recent medical records prior to death to assess whether each participant had normal cognition, MCI, or dementia based on the Movement Disorder Society (MDS) Task Force guidelines for diagnostic criteria for PD-MCI and PDD. Results There were 174 participants with an average of 77.1 years old at the time of autopsy, 31.6% of whom were women. Participants completed an average of 15.99 years of education and suffered from PD for an average of 15.86 years. Depression was present in 41 participants (23.56%). Dementia was diagnosed in 129 participants (74.13%), whereas 18 participants had normal cognition (10.34%). MCI accounted for 14 participants (8.04%). Another 4 participants were postulated to have MCI based on the records we analyzed, however due to missing data they did not meet the strict criteria. In total, 13 (7.04%) of the participants had insufficient data to use the MDS diagnostic criteria to determine their cognitive status. Discussion The majority of participants developed PDD at some point in their disease course. However, there were a subset of patients with similar disease duration who had MCI that did not progress to PDD. Further investigation should be done to explore the cognitive domains affected by MCI and dementia to determine whether MCI is a separate disease entity or part of the spectrum of neurocognitive disorder.