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Neuropsychiatric symptoms and cognitive abilities over the initial quinquennium of Parkinson disease
Journal article   Open access   Peer reviewed

Neuropsychiatric symptoms and cognitive abilities over the initial quinquennium of Parkinson disease

Daniel Weintraub, Chelsea Caspell-Garcia, Tanya Simuni, Hyunkeun R Cho, Christopher S Coffey, Dag Aarsland, Roy N Alcalay, Matthew J Barrett, Lana M Chahine, Jamie Eberling, …
Annals of clinical and translational neurology, Vol.7(4), pp.449-461
04/2020
DOI: 10.1002/acn3.51022
PMCID: PMC7187707
PMID: 32285645
url
https://doi.org/10.1002/acn3.51022View
Published (Version of record) Open Access

Abstract

To determine the evolution of numerous neuropsychiatric symptoms and cognitive abilities in Parkinson disease from disease onset. Prospectively collected, longitudinal (untreated, disease onset to year 5), observational data from Parkinson's Progression Markers Initiative annual visits was used to evaluate prevalence, correlates, and treatment of 10 neuropsychiatric symptoms and cognitive impairment in Parkinson disease participants and matched healthy controls. Of 423 Parkinson disease participants evaluated at baseline, 315 (74.5%) were assessed at year 5. Eight neuropsychiatric symptoms studied increased in absolute prevalence by 6.2-20.9% at year 5 relative to baseline, and cognitive impairment increased by 2.7-6.2%. In comparison, the frequency of neuropsychiatric symptoms in healthy controls remained stable or declined over time. Antidepressant and anxiolytic/hypnotic use in Parkinson disease were common at baseline and increased over time (18% to 27% for the former; 13% to 24% for the latter); antipsychotic and cognitive-enhancing medication use was uncommon throughout (2% and 5% of patients at year 5); and potentially harmful anticholinergic medication use was common and increased over time. At year 5 the cross-sectional prevalence for having three or more neuropsychiatric disorders/cognitive impairment was 56% for Parkinson disease participants versus 13% for healthy controls, and by then seven of the examined disorders had either occurred or been treated at some time point in the majority of Parkinson disease patients. Principal component analysis suggested an affective disorder subtype only. Neuropsychiatric features in Parkinson disease are common from the onset, increase over time, are frequently comorbid, and fluctuate in severity.
Adult Aged Aged, 80 and over Behavioral Symptoms - drug therapy Behavioral Symptoms - epidemiology Behavioral Symptoms - etiology Behavioral Symptoms - physiopathology Cognitive Dysfunction - drug therapy Cognitive Dysfunction - epidemiology Cognitive Dysfunction - etiology Cognitive Dysfunction - physiopathology Disease Progression Female Humans Longitudinal Studies Male Middle Aged Parkinson Disease - complications Parkinson Disease - drug therapy Parkinson Disease - epidemiology Parkinson Disease - physiopathology Prevalence

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