This Article  • Full text  • PDF  • Reply to article  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (193)  • Contact me when this article is cited  Related Content  • Similar articles in this journal  Topic Collections  • Dementias  • Movement Disorders  • Parkinson Disease/ Parkinsonian Disorders  • Alert me on articles by topic

An 8-Year Prospective Study

Dag Aarsland, MD, PhD; Kjeld Andersen, MD, PhD; Jan P. Larsen, MD, PhD; Anette Lolk, MD, PhD

Arch Neurol. 2003;60:387-392.

Background  Few longitudinal studies of dementia in Parkinson disease (PD) have been reported, and the proportion of patients with PD who eventually develop dementia is unknown.

Objective  To examine the 8-year prevalence, characteristics, and risk factors of dementia in patients with PD.

Methods  Patients were recruited from an epidemiological study of PD in the county of Rogaland, Norway, using explicit criteria for PD. Subjects with cognitive impairment at disease onset were excluded. A semistructured caregiver-based interview, cognitive rating scales, and neuropsychological tests were used to diagnose dementia according to criteria from the Diagnostic and Statistical Manual of Mental Disorders, Revised Third Edition at baseline and 4 and 8 years later. A population-based sample of 3295 subjects in the municipality of Odense, Denmark, was used as a comparison group and examined at baseline and after 2 and 5 years.

Results  We included 224 patients with PD (116 women). At baseline, 51 patients (26%) had dementia. Fifty-five patients died, and 10 refused follow-up without their dementia status known. Forty-three and 28 new cases of dementia were identified at the 4- and 8-year evaluations, respectively. The 4-year prevalence of dementia in PD was nearly 3 times higher than in the non-PD group. The 8-year prevalence in PD was 78.2% (95% confidence interval [CI], 71.1-84.0). Risk factors for dementia were hallucinations before baseline (odds ratio [OR] = 3.1; 95% CI, 1.6-6.2) and akinetic-dominant or mixed tremor/akinetic PD (OR = 3.3; 95% CI, 1.2-8.5).

Conclusions  More than three quarters of this representative PD cohort developed dementia during the 8-year study period. Early hallucinations and akinetic-dominant PD were associated with an increased risk of dementia.

Per Kragh-Sørensen, MD, DMSc

From the Section of Geriatric Psychiatry, Psychiatric Clinic (Dr Aarsland), and Department of Neurology (Dr Larsen), Central Hospital of Rogaland, Stavanger, Norway; the Institutes of Psychiatry (Dr Aarsland) and Neurology (Dr Larsen), University of Bergen, Bergen, Norway; and the Department of Psychiatry, Odense University Hospital, Odense, Denmark (Drs Andersen, Lolk, and Kragh-Sørensen).

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Functional Convergence of Dopaminergic and Cholinergic Input Is Critical for Hippocampus-Dependent Working Memory
Wisman et al.
J. Neurosci. 2008;28:7797-7807.
ABSTRACT | FULL TEXT  

Invited Article: Changing concepts in Parkinson disease: Moving beyond the Decade of the Brain
Marras and Lang
Neurology 2008;70:1996-2003.
ABSTRACT | FULL TEXT  

Patients Homozygous and Heterozygous for SNCA Duplication in a Family With Parkinsonism and Dementia
Ikeuchi et al.
Arch Neurol 2008;65:514-519.
ABSTRACT | FULL TEXT  

Dementia and survival in Parkinson disease: A 12-year population study
Buter et al.
Neurology 2008;70:1017-1022.
ABSTRACT | FULL TEXT  

Sex and Gender in Older Adults' Experience of Parkinson's Disease
Solimeo
J. Gerontol. B Psychol. Sci. Soc. Sci. 2008;63:S42-S48.
ABSTRACT | FULL TEXT  

REM sleep behavior disorder predicts cognitive impairment in Parkinson disease without dementia
Vendette et al.
Neurology 2007;69:1843-1849.
ABSTRACT | FULL TEXT  

Cognitive impairment in Parkinson's disease
Verbaan et al.
J. Neurol. Neurosurg. Psychiatry 2007;78:1182-1187.
ABSTRACT | FULL TEXT  

Dementia with Lewy bodies and Parkinson's disease with dementia: where two worlds collide
McKeith
PN 2007;7:374-382.
ABSTRACT | FULL TEXT  

Presentation and Management of Psychosis in Parkinson's Disease and Dementia With Lewy Bodies
Weintraub and Hurtig
Am. J. Psychiatry 2007;164:1491-1498.
FULL TEXT  

Profile of cognitive impairment in dementia associated with Parkinson's disease compared with Alzheimer's disease
Bronnick et al.
J. Neurol. Neurosurg. Psychiatry 2007;78:1064-1068.
ABSTRACT | FULL TEXT  

Alzheimer and Parkinson Diagnoses in Progranulin Null Mutation Carriers in an Extended Founder Family
Brouwers et al.
Arch Neurol 2007;64:1436-1446.
ABSTRACT | FULL TEXT  

FMR1 Alleles in Parkinson's Disease: Relation to Cognitive Decline and Hallucinations, A Longitudinal Study
Kurz et al.
J Geriatr Psychiatry Neurol 2007;20:89-92.
ABSTRACT  

Imaging in dementia
MURRAY
Imaging 2007;19:133-141.
ABSTRACT | FULL TEXT  

Catechol O-Methyltransferase val158met Genotype Influences Frontoparietal Activity during Planning in Patients with Parkinson's Disease
Williams-Gray et al.
J. Neurosci. 2007;27:4832-4838.
ABSTRACT | FULL TEXT  

NICE guideline for Parkinson's disease
Stewart
Age Ageing 2007;36:240-242.
FULL TEXT  

Developing the NICE/SCIE Guidelines for Dementia Care: The Challenges of Enhancing the Evidence Base for Social and Health Care
Gould and Kendall
Br J Soc Work 2007;37:475-490.
ABSTRACT | FULL TEXT  

A magnetic resonance imaging study of patients with Parkinson's disease with mild cognitive impairment and dementia using voxel-based morphometry
Beyer et al.
J. Neurol. Neurosurg. Psychiatry 2007;78:254-259.
ABSTRACT | FULL TEXT  

Neuropsychiatric symptoms in patients with Parkinson's disease and dementia: frequency, profile and associated care giver stress
Aarsland et al.
J. Neurol. Neurosurg. Psychiatry 2007;78:36-42.
ABSTRACT | FULL TEXT  

Clinical phenotype of Parkinson disease dementia.
Galvin et al.
Neurology 2006;67:1605-1611.
ABSTRACT | FULL TEXT  

Attentional deficits affect activities of daily living in dementia-associated with Parkinson's disease
Bronnick et al.
J. Neurol. Neurosurg. Psychiatry 2006;77:1136-1142.
ABSTRACT | FULL TEXT  

Excessive daytime sleepiness in Parkinson disease: is it the drugs or the disease?
Gjerstad et al.
Neurology 2006;67:853-858.
ABSTRACT | FULL TEXT  

Motor subtype and cognitive decline in Parkinson's disease, Parkinson's disease with dementia, and dementia with Lewy bodies
Burn et al.
J. Neurol. Neurosurg. Psychiatry 2006;77:585-589.
ABSTRACT | FULL TEXT  

Practice Parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.
Miyasaki et al.
Neurology 2006;66:996-1002.
ABSTRACT | FULL TEXT  

Cognitive changes in Parkinson's disease during subthalamic stimulation: a clinicopathologic study
Valldeoriola et al.
J. Neurol. Neurosurg. Psychiatry 2006;77:565-566.
FULL TEXT  

Diagnosis and management of dementia with Lewy bodies: Third report of the DLB consortium
McKeith et al.
Neurology 2005;65:1863-1872.
ABSTRACT | FULL TEXT  

Visual dysfunction in Parkinson disease without dementia
Uc et al.
Neurology 2005;65:1907-1913.
ABSTRACT | FULL TEXT  

Dementia in Parkinson disease: Functional imaging of cholinergic and dopaminergic pathways
Hilker et al.
Neurology 2005;65:1716-1722.
ABSTRACT | FULL TEXT  

Benefits of rivastigmine on attention in dementia associated with Parkinson disease
Wesnes et al.
Neurology 2005;65:1654-1656.
ABSTRACT | FULL TEXT  

Psychiatric Complications in Parkinson Disease
Weintraub and Stern
AJGP 2005;13:844-851.
ABSTRACT | FULL TEXT  

Cognitive Predictors of Dementia in Parkinson's Disease: A Community-Based, 4-Year Longitudinal Study
Janvin et al.
J Geriatr Psychiatry Neurol 2005;18:149-154.
ABSTRACT  

Prognosis of Parkinson Disease: Risk of Dementia and Mortality: The Rotterdam Study
de Lau et al.
Arch Neurol 2005;62:1265-1269.
ABSTRACT | FULL TEXT  

Cholinesterase inhibitors for treatment of dementia associated with Parkinson's disease
Cummings
J. Neurol. Neurosurg. Psychiatry 2005;76:903-904.
FULL TEXT  

Sleep issues in Parkinson's disease
Adler and Thorpy
Neurology 2005;64:S12-S20.
ABSTRACT | FULL TEXT  

Saccadic eye movement changes in Parkinson's disease dementia and dementia with Lewy bodies
Mosimann et al.
Brain 2005;128:1267-1276.
ABSTRACT | FULL TEXT  

Clinical deficits correlate with regional cerebral atrophy in progressive supranuclear palsy
Cordato et al.
Brain 2005;128:1259-1266.
ABSTRACT | FULL TEXT  

Cognitive status correlates with neuropathologic stage in Parkinson disease
Braak et al.
Neurology 2005;64:1404-1410.
ABSTRACT | FULL TEXT  

Temporal lobe atrophy on MRI in Parkinson disease with dementia: A comparison with Alzheimer disease and dementia with Lewy bodies
Tam et al.
Neurology 2005;64:861-865.
ABSTRACT | FULL TEXT  

Visual perception in Parkinson disease dementia and dementia with Lewy bodies
Mosimann et al.
Neurology 2004;63:2091-2096.
ABSTRACT | FULL TEXT  

Rivastigmine for Dementia Associated with Parkinson's Disease
Emre et al.
NEJM 2004;351:2509-2518.
ABSTRACT | FULL TEXT  

Parkinson's Disease Dementia -- A First Step?
Press
NEJM 2004;351:2547-2549.
FULL TEXT  

The Rate of Cognitive Decline in Parkinson Disease
Aarsland et al.
Arch Neurol 2004;61:1906-1911.
ABSTRACT | FULL TEXT  

Are Parkinson's Disease with dementia and Dementia with lewy Bodies the Same Entity?
Aarsland et al.
J Geriatr Psychiatry Neurol 2004;17:137-145.
ABSTRACT  

Lack of Familial Aggregation of Parkinson Disease and Alzheimer Disease
Levy et al.
Arch Neurol 2004;61:1033-1039.
ABSTRACT | FULL TEXT  

The cognitive ability of an incident cohort of Parkinson's patients in the UK. The CamPaIGN study
Foltynie et al.
Brain 2004;127:550-560.
ABSTRACT | FULL TEXT  

Cortical Lewy body disease
Burn
J. Neurol. Neurosurg. Psychiatry 2004;75:175-178.
FULL TEXT  

The origin of motor fluctuations in Parkinson's disease: Importance of dopaminergic innervation and basal ganglia circuits
Obeso et al.
Neurology 2004;62:S17-30.
ABSTRACT | FULL TEXT  

Practice Parameter: evaluation and treatment of depression, psychosis, and dementia in Parkinson disease (an evidence-based review): report of the Quality Standards Subcommittee of the American Academy of Neurology.
Miyasaki et al.
Neurology 2006;66:996-1002.
ABSTRACT | FULL TEXT