Tags

Type your tag names separated by a space and hit enter

Mild cognitive impairment is common in Parkinson's disease patients with normal Mini-Mental State Examination (MMSE) scores.
Parkinsonism Relat Disord. 2009 Mar; 15(3):226-31.PR

Abstract

PURPOSE

Cognitive impairment occurs in the majority of Parkinson's disease (PD) patients, but little is known about detection of mild cognitive impairment (MCI) in this population. We report on the frequency and characteristics of cognitive deficits in PD patients with intact global cognition based on Mini-Mental State Examination (MMSE) performance.

METHODS

One hundred and six PD patients with normal age- and education-adjusted MMSE scores (mean [SD] score=29.1 [1.1]) were administered standardized neuropsychological tests assessing memory, executive function, and attention. Impairment on a cognitive domain was a low score (i.e., >or=1.5 SD below the published normative mean) on at least two measures or tests (for memory and executive abilities) or a single measure (for attention).

RESULTS

Mild cognitive impairment was found in 29.2% of PD patients, with 17.9% demonstrating single domain and 11.3% multiple domain impairment. Memory and attention impairment were most common (15.1% and 17.0%, respectively), followed by executive impairment (8.5%). Depending on the measure of disease severity chosen, increasing age and disease severity, anti-anxiety medication use, and a suggestion for increasing severity of daytime sleepiness were independent predictors of cognitive impairment.

CONCLUSIONS

Cognitive deficits are common in PD patients with "normal" cognition based on MMSE performance, suggesting that MCI is under-recognized in clinical practice due to routine use of insensitive screening instruments. In contrast with some previous reports, early memory impairment may be as common as either executive or attentional deficits in PD. In addition, psychiatric medication use and daytime sleepiness may be reversible or treatable contributors to cognitive impairment.

Authors+Show Affiliations

Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, USA.No affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural

Language

eng

PubMed ID

18595765

Citation

Mamikonyan, Eugenia, et al. "Mild Cognitive Impairment Is Common in Parkinson's Disease Patients With Normal Mini-Mental State Examination (MMSE) Scores." Parkinsonism & Related Disorders, vol. 15, no. 3, 2009, pp. 226-31.
Mamikonyan E, Moberg PJ, Siderowf A, et al. Mild cognitive impairment is common in Parkinson's disease patients with normal Mini-Mental State Examination (MMSE) scores. Parkinsonism Relat Disord. 2009;15(3):226-31.
Mamikonyan, E., Moberg, P. J., Siderowf, A., Duda, J. E., Have, T. T., Hurtig, H. I., Stern, M. B., & Weintraub, D. (2009). Mild cognitive impairment is common in Parkinson's disease patients with normal Mini-Mental State Examination (MMSE) scores. Parkinsonism & Related Disorders, 15(3), 226-31. https://doi.org/10.1016/j.parkreldis.2008.05.006
Mamikonyan E, et al. Mild Cognitive Impairment Is Common in Parkinson's Disease Patients With Normal Mini-Mental State Examination (MMSE) Scores. Parkinsonism Relat Disord. 2009;15(3):226-31. PubMed PMID: 18595765.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Mild cognitive impairment is common in Parkinson's disease patients with normal Mini-Mental State Examination (MMSE) scores. AU - Mamikonyan,Eugenia, AU - Moberg,Paul J, AU - Siderowf,Andrew, AU - Duda,John E, AU - Have,Tom Ten, AU - Hurtig,Howard I, AU - Stern,Matthew B, AU - Weintraub,Daniel, Y1 - 2008/07/02/ PY - 2008/02/10/received PY - 2008/05/09/revised PY - 2008/05/12/accepted PY - 2008/7/4/pubmed PY - 2009/4/21/medline PY - 2008/7/4/entrez SP - 226 EP - 31 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 15 IS - 3 N2 - PURPOSE: Cognitive impairment occurs in the majority of Parkinson's disease (PD) patients, but little is known about detection of mild cognitive impairment (MCI) in this population. We report on the frequency and characteristics of cognitive deficits in PD patients with intact global cognition based on Mini-Mental State Examination (MMSE) performance. METHODS: One hundred and six PD patients with normal age- and education-adjusted MMSE scores (mean [SD] score=29.1 [1.1]) were administered standardized neuropsychological tests assessing memory, executive function, and attention. Impairment on a cognitive domain was a low score (i.e., >or=1.5 SD below the published normative mean) on at least two measures or tests (for memory and executive abilities) or a single measure (for attention). RESULTS: Mild cognitive impairment was found in 29.2% of PD patients, with 17.9% demonstrating single domain and 11.3% multiple domain impairment. Memory and attention impairment were most common (15.1% and 17.0%, respectively), followed by executive impairment (8.5%). Depending on the measure of disease severity chosen, increasing age and disease severity, anti-anxiety medication use, and a suggestion for increasing severity of daytime sleepiness were independent predictors of cognitive impairment. CONCLUSIONS: Cognitive deficits are common in PD patients with "normal" cognition based on MMSE performance, suggesting that MCI is under-recognized in clinical practice due to routine use of insensitive screening instruments. In contrast with some previous reports, early memory impairment may be as common as either executive or attentional deficits in PD. In addition, psychiatric medication use and daytime sleepiness may be reversible or treatable contributors to cognitive impairment. SN - 1353-8020 UR - https://www.unboundmedicine.com/medline/citation/18595765/Mild_cognitive_impairment_is_common_in_Parkinson's_disease_patients_with_normal_Mini_Mental_State_Examination__MMSE__scores_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353-8020(08)00163-6 DB - PRIME DP - Unbound Medicine ER -