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Karen Marder, MD, MPH; Ming-Xin Tang, PhD; Lucien Cote, MD; Yaakov Stern, PhD; Richard Mayeux, MD, MSE

Arch Neurol. 1995;52(7):695-701.

Abstract
Objectives
To estimate the frequency and determine the risk factors for incident dementia in community-dwelling patients with Parkinson's disease (PD) and in control subjects.

Design
Prospective cohort study. During a 3.5-year period, 140 patients with idiopathic PD without evidence of dementia and 572 nondemented control subjects were identified in the community of Washington Heights—Inwood in New York, NY. All subjects underwent neurological and neuropsychological evaluations and follow-up examinations.

Results
Twenty-seven patients with PD (19.2%) became demented throughout 2 years, as compared with 87 (15.2%) of the control subjects. The relative risk (RR) for the development of dementia with PD was 1.7 (95% confidence interval [CI], 1.1 to 2.7) after adjusting for age, education, and gender. Predictive features of incident dementia were an extrapyramidal score greater than 25 (RR, 3.56; 95% CI, 1.4 to 8.9) and a Hamilton Depression Rating Scale score greater than 10 (RR, 3.55; 95% CI, 1.6 to 7.9).

Conclusion
Patients with PD, especially those with severe extrapyramidal signs, have almost twice the risk for the development of dementia than do community-dwelling control subjects.

Author Affiliations
From the Gertrude H. Sergievsky Center (Drs Marder, Tang, Stern, and Mayeux), the Departments of Neurology (Drs Marder, Tang, Cote, Stern, and Mayeux) and Psychiatry (Drs Stern and Mayeux); College of Physicians and Surgeons; the Center for Alzheimer's Disease Research in the City of New York (Drs Marder, Tang, Cote, Stern, and Mayeux), and the Division of Epidemiology, School of Public Health, Columbia University (Dr Mayeux), New York, NY.

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