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Severity of mild cognitive impairment in early Parkinson's disease contributes to poorer quality of life

Lookup NU author(s): Dr Rachael LawsonORCiD, Professor Alison Yarnall, Dr Gordon Duncan, Dr Tien Kheng Khoo, Daniel Collerton, Professor John-Paul TaylorORCiD, Professor David BurnORCiD

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This work is licensed under a Creative Commons Attribution 4.0 International License (CC BY 4.0).


Abstract

BACKGROUND: Poor quality of life (QoL) is a feature of people with Parkinson's disease (PD) who develop dementia. The relationship between mild cognitive impairment in PD (PD-MCI) and QoL is less clear. To address this, we studied the impact of varying severities of cognitive impairment on QoL in a cohort of non-demented patients with early PD.METHOD: Patients with newly diagnosed PD (n = 219) and age and sex matched healthy controls (n = 99) completed a schedule of neuropsychological tests, in addition to scales assessing QoL (PDQ-39), depression, sleep, neuropsychiatric symptoms and a clinical examination. The Movement Disorder Society criteria were used to define and classify PD-MCI.RESULTS: Participants with PD-MCI were significantly older than those with normal cognition, had more severe motor symptoms, scored higher for depression and had poorer quality of life. Logistic regression showed that mild cognitive impairment, independent of other factors, was an indicator of poorer QoL. Using cognitive performance 2.0 standard deviations (SD) below normative data as a cut-off to define PD-MCI, there was a significant difference in QoL scores between patients with PD-MCI and those classified as having normal cognition. Subjects with less severe mild cognitive impairment did not exhibit significant differences in QoL.CONCLUSIONS: PD-MCI is a significant, independent factor contributing to poorer QoL in patients with newly diagnosed PD. Those classified with greatest impairment (2.0 SD below normal values) have lower QoL. This has implications for clinical practice and future interventions targeting cognitive impairments


Publication metadata

Author(s): Lawson RA, Yarnall AJ, Duncan GW, Khoo TK, Breen DP, Barker RA, Collerton D, Taylor JP, Burn DJ

Publication type: Article

Publication status: Published

Journal: Parkinsonism & Related Disorders

Year: 2014

Volume: 20

Issue: 10

Pages: 1071-1075

Print publication date: 01/10/2014

Online publication date: 18/07/2014

Acceptance date: 08/07/2014

Date deposited: 07/11/2014

ISSN (print): 1353-8020

ISSN (electronic): 1873-5126

Publisher: Elsevier Ltd

URL: http://dx.doi.org/10.1016/j.parkreldis.2014.07.004

DOI: 10.1016/j.parkreldis.2014.07.004

PubMed id: 25074728


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Funding

Funder referenceFunder name
Raymond and Beverly Sackler Studentship
UK NIHR Biomedical Research Unit in Lewy Body Dementia awards
UK NIHR Biomedical Research Centre award
UK NIHR Biomedical Research Centre for Ageing and Age-Related Disease
J-0802Parkinson's UK
088441/Z/09/ZWellcome Trust

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