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The association between cognitive impairment and neuropsychiatric symptoms in patients with Parkinson's disease dementia

Published online by Cambridge University Press:  27 July 2012

Wei-Ju Lee ,
Chia-Fen Tsai ,
Serge Gauthier ,
Shuu-Jiun Wang  and
Jong-Ling Fuh
Wei-Ju Lee
Affiliation:
Department of Neurology, Taichung Veterans General Hospital, Taichung, Taiwan Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan Institute of Clinical Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
Chia-Fen Tsai
Affiliation:
Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Institute of Brain Science, National Yang-Ming University Schools of Medicine, Taipei, Taiwan
Serge Gauthier
Affiliation:
Department of Neurology and Neurosurgery, Psychiatry, Medicine, McGill University, Montreal, Quebec, Canada
Shuu-Jiun Wang
Affiliation:
Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
Jong-Ling Fuh*
Affiliation:
Faculty of Medicine, National Yang-Ming University Schools of Medicine, Taipei, Taiwan Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan
*
Correspondence should be addressed to: Dr Jong-Ling Fuh, Neurological Institute, Taipei Veterans General Hospital, Taipei 112, Taiwan. Phone: +886-2-28762522; Fax: +886-2-28765215. Email: jlfuh@vghtpe.gov.tw.
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Abstract

Background: Neuropsychiatric symptoms (NPS) are common in patients with dementia associated with Parkinson's disease (PDD). The relationship between cognition and NPS in PDD has not been well studied.

Methods: Patients diagnosed with PDD were assessed for cognitive function and NPS. The instruments used were the Neuropsychiatric Inventory (NPI), Mini-Mental State Examination (MMSE), and semantic verbal fluency according to the recommendation of the Movement Disorder Society Task Force.

Results: We evaluated 127 PDD patients (76 males/51 females; mean age 77 ± 6.3 years). Their mean MMSE score was 17 ± 6.5 and the mean NPI score was 19 ± 20.4. The most prevalent NPI items were anxiety (57.5%), sleep problems (53.5%), and apathy (52.0%). Principal component factor analysis revealed that 12 items formed three factors, namely “mood and psychosis” (delusion, hallucination, agitation, depression, anxiety, apathy, and irritability), “vegetative” (sleep and appetite problems), and “frontal” (euphoria, disinhibition, and aberrant motor behavior). Symptoms of hallucination were significantly associated with MMSE score, even after controlling for the confounding variables.

Conclusion: NPS are common and diverse among patients with PDD. Three specific subgroups of NPS were identified. Hallucination was significantly correlated with cognitive impairment, and could be a predictor of cognition in PDD patients.

Keywords

Parkinson's diseasecognitive functiondementiafactor analysisneuropsychiatric symptoms
Type
Research Article
Information
International Psychogeriatrics , Volume 24 , Issue 12 , December 2012 , pp. 1980 - 1987
Copyright
Copyright © International Psychogeriatric Association 2012

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