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Relationships among cognitive impairment, sleep, and fatigue in Parkinson's disease using the MDS-UPDRS.
Parkinsonism Relat Disord. 2014 Nov; 20(11):1135-9.PR

Abstract

BACKGROUND

Non-motor complications of Parkinson's disease (PD), specifically cognitive impairment, sleep disturbances, and fatigue, are recognized as important contributors to poor patient outcomes and quality of life. How sleep problems and fatigue interrelate and impact cognitive function, however, has not systematically been investigated across the stages of PD. The aim of our study was to investigate the relationships among cognitive impairment, night-time sleep problems, daytime sleepiness, and fatigue across all severities of PD.

METHODS

We examined these non-motor problems using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) in a study of 1319 PD patients drawn from three large cohort studies: the Parkinson's Progressive Markers Initiative, the Rush University PD Cognitive-Behavioral-Imaging study, and the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Clinimetric testing program study, which spanned the gamut of disease, from early to advanced PD. Generalized linear mixed models with logit linking functions and covariates including study cohort, age, PD duration, and presence/absence of PD medications were used to examine relationships between these three non-motor symptoms and cognitive impairment.

RESULTS

Of these three frequent, and often inter-twined, non-motor complications, greater daytime sleepiness and fatigue were associated with worse cognitive impairment across the full spectrum of PD (F[16,1158] = 2.40 and F[16,1158] = 3.45 respectively, p's < 0.0005), but an association with night-time sleep was not detected (p = 0.83).

CONCLUSIONS

Given this association of daytime sleepiness and fatigue with cognitive impairment, clinical monitoring for these problems should be considered across all points in the PD spectrum, from early to more advanced disease.

Authors+Show Affiliations

Rush University Medical Center, Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Chicago, IL, USA. Electronic address: Jennifer_G_Goldman@rush.edu.Rush University Medical Center, Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Chicago, IL, USA.University of Illinois at Chicago, College of Medicine, Chicago, IL, USA.University of Texas School of Public Health, Division of Biostatistics, Houston, TX, USA.Rush University Medical Center, Department of Neurological Sciences, Section of Parkinson Disease and Movement Disorders, Chicago, IL, USA.

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

25150770

Citation

Goldman, Jennifer G., et al. "Relationships Among Cognitive Impairment, Sleep, and Fatigue in Parkinson's Disease Using the MDS-UPDRS." Parkinsonism & Related Disorders, vol. 20, no. 11, 2014, pp. 1135-9.
Goldman JG, Stebbins GT, Leung V, et al. Relationships among cognitive impairment, sleep, and fatigue in Parkinson's disease using the MDS-UPDRS. Parkinsonism Relat Disord. 2014;20(11):1135-9.
Goldman, J. G., Stebbins, G. T., Leung, V., Tilley, B. C., & Goetz, C. G. (2014). Relationships among cognitive impairment, sleep, and fatigue in Parkinson's disease using the MDS-UPDRS. Parkinsonism & Related Disorders, 20(11), 1135-9. https://doi.org/10.1016/j.parkreldis.2014.08.001
Goldman JG, et al. Relationships Among Cognitive Impairment, Sleep, and Fatigue in Parkinson's Disease Using the MDS-UPDRS. Parkinsonism Relat Disord. 2014;20(11):1135-9. PubMed PMID: 25150770.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Relationships among cognitive impairment, sleep, and fatigue in Parkinson's disease using the MDS-UPDRS. AU - Goldman,Jennifer G, AU - Stebbins,Glenn T, AU - Leung,Vania, AU - Tilley,Barbara C, AU - Goetz,Christopher G, Y1 - 2014/08/13/ PY - 2014/04/12/received PY - 2014/07/17/revised PY - 2014/08/02/accepted PY - 2014/8/25/entrez PY - 2014/8/26/pubmed PY - 2015/7/21/medline KW - Cognitive impairment KW - Daytime sleepiness KW - Fatigue KW - Movement Disorder Society-Unified Parkinson's Disease Rating Scale (MDS-UPDRS) KW - Parkinson's disease SP - 1135 EP - 9 JF - Parkinsonism & related disorders JO - Parkinsonism Relat Disord VL - 20 IS - 11 N2 - BACKGROUND: Non-motor complications of Parkinson's disease (PD), specifically cognitive impairment, sleep disturbances, and fatigue, are recognized as important contributors to poor patient outcomes and quality of life. How sleep problems and fatigue interrelate and impact cognitive function, however, has not systematically been investigated across the stages of PD. The aim of our study was to investigate the relationships among cognitive impairment, night-time sleep problems, daytime sleepiness, and fatigue across all severities of PD. METHODS: We examined these non-motor problems using the Movement Disorder Society-Sponsored Revision of the Unified Parkinson's Disease Rating Scale (MDS-UPDRS) in a study of 1319 PD patients drawn from three large cohort studies: the Parkinson's Progressive Markers Initiative, the Rush University PD Cognitive-Behavioral-Imaging study, and the Movement Disorder Society-Unified Parkinson's Disease Rating Scale Clinimetric testing program study, which spanned the gamut of disease, from early to advanced PD. Generalized linear mixed models with logit linking functions and covariates including study cohort, age, PD duration, and presence/absence of PD medications were used to examine relationships between these three non-motor symptoms and cognitive impairment. RESULTS: Of these three frequent, and often inter-twined, non-motor complications, greater daytime sleepiness and fatigue were associated with worse cognitive impairment across the full spectrum of PD (F[16,1158] = 2.40 and F[16,1158] = 3.45 respectively, p's < 0.0005), but an association with night-time sleep was not detected (p = 0.83). CONCLUSIONS: Given this association of daytime sleepiness and fatigue with cognitive impairment, clinical monitoring for these problems should be considered across all points in the PD spectrum, from early to more advanced disease. SN - 1873-5126 UR - https://www.unboundmedicine.com/medline/citation/25150770/Relationships_among_cognitive_impairment_sleep_and_fatigue_in_Parkinson's_disease_using_the_MDS_UPDRS_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1353-8020(14)00296-X DB - PRIME DP - Unbound Medicine ER -