%0 Journal Article
%T Predictors of Cognitive Decline in the Early Stages of Parkinson's Disease: A Brief Cognitive Assessment Longitudinal Study
%A Paulo Bugalho
%A Miguel Viana-Baptista
%J Parkinson's Disease
%D 2013
%I Hindawi Publishing Corporation
%R 10.1155/2013/912037
%X Our objectives were to perform a longitudinal assessment of mental status in early stage Parkinson¡¯s disease (PD) patients, with brief neuropsychological tests, in order to find predictive factors for cognitive decline. Sixty-one, early stage, and nondemented patients were assessed twice, over a 2-year interval, with a global cognitive test (mini-mental state examination (MMSE)) and a frontal function test (frontal assessment battery (FAB)) and motor function scales. Dementia and hallucinations were diagnosed according to the DSM-IV criteria. Cognitive function scores did not decrease significantly, except for FAB lexical fluency score. Four patients presented with dementia at followup. The MMSE score below cut-off, worse gait dysfunction, the nontremor motor subtype, and hallucinations were significantly related to dementia. Rigidity and speech dysfunction were related to dementia and a decrease in FAB scores. We can conclude that decline in the MMSE and FAB scores is small and heterogeneous in the early stages of PD. Scores below cut-off in the MMSE could be helpful to predict dementia. Nontremor motor deficits could be predictive factors for frontal cognitive decline and dementia. 1. Introduction Parkinson¡¯s disease is a movement disorder, defined by a combination of tremor, rigidity, bradykinesia, and gait disturbances [1]. Lately, a constellation of nonmotor symptoms has also been described [2]. Cognitive dysfunction, which can ultimately lead to dementia in a great number of cases [3], is a cause of great incapacity in PD. As therapeutic alternatives develop [4], the need for an early detection of cognitive deficits and for accurate prediction of cognitive outcome increases. Brief cognitive tests could be useful for a rapid screening of patients at higher risk for cognitive decline. They also could be of use for following cognitive decline and predicting cognitive outcome. Noncognitive symptoms at the baseline, like motor dysfunction severity, or specific motor symptoms could also be useful as cognitive outcome predictors. Several studies have defined significant clinical heterogeneity at disease onset [5, 6] which could determine prognosis. In previous work, we found that early stage, nondemented PD patients presented with significantly lower scores in the frontal assessment battery (FAB) and the mini-mental state examination (MMSE), when compared to non-PD aged controls, and that MMSE scores were related to nontremor motor scores [7]. In the present study, our objectives were to perform a longitudinal analysis of this cohort, in order to assess
%U http://www.hindawi.com/journals/pd/2013/912037/