Journal
PARKINSONISM & RELATED DISORDERS
Volume 27, Issue -, Pages 47-53Publisher
ELSEVIER SCI LTD
DOI: 10.1016/j.parkreldis.2016.04.009
Keywords
Parkinson's disease; Quality of life; Mild cognitive impairment; Dementia; Attention
Categories
Funding
- Parkinson's UK [J-0802]
- Lockhart Parkinson's Disease Research Fund
- National Institute for Health Research (NIHR) Newcastle Biomedical Research Unit based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University
- NIHR Biomedical Research Centre
- Biomedical Research Unit, Newcastle University
- Michael J. Fox Foundation (MJFF)
- Teva-Lundbeck
- UCB
- GlaxoSmithKline (GSK)
- Genus
- Britannia Pharmaceuticals Ltd.
- AbbVie
- UCB Pharma
- Movement Disorder Society
- Academy of Medical Sciences
- Rosetrees Trust
- Stevenage Biosciences Catalyst
- Addenbrooke's Charitable Trust
- NIHR
- Parkinson's UK
- Cure Parkinson's Trust
- MRC
- ACT
- EU
- GE Healthcare
- Flynn pharmaceuticals
- Wellcome Trust
- Acadia Pharmaceuticals
- Wellcome Trust [103838/Z/14/Z] Funding Source: Wellcome Trust
- MRC [MC_U105597119] Funding Source: UKRI
- Medical Research Council [MC_U105597119] Funding Source: researchfish
- Parkinson's UK [J-0802] Funding Source: researchfish
- Wellcome Trust [103838/Z/14/Z] Funding Source: researchfish
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Introduction: Parkinson's disease dementia (PDD) is associated with poorer quality of life (QoL). Prior to the onset of PDD, many patients experience progressive cognitive impairment. There is a paucity of longitudinal studies investigating the effects of cognitive decline on QoL. This study aimed to determine the longitudinal impact of cognitive change on QoL in an incident PD cohort. Methods: Recently diagnosed patients with PD (n = 212) completed a schedule of neuropsychological assessments and QoL measures; these were repeated after 18 (n = 190) and 36 months (n = 158). Mild cognitive impairment (PD-MCI) was classified with reference to the Movement Disorder Society criteria. Principal component analysis was used to reduce 10 neuropsychological tests to three cognitive factors: attention, memory/executive function, and global cognition. Results: Baseline PD-MCI was a significant contributor to QoL (beta = 0.2, p < 0.01). For those subjects (9%) who developed dementia, cognitive function had a much greater impact on QoL (beta = 10.3, p < 0.05). Multivariate modelling showed attentional deficits had the strongest predictive power (beta =-23, p < 0.01); brief global tests only modestly predicted decline in QoL (beta = 0.4, p < 0.01). Conclusions: PO,MCI was associated with poorer QoL over three years follow up. Cognitive impairment had a greater impact on QoL in individuals who developed dementia over follow-up. Impaired attention was a significant determinant of QoL in PD. Interventions which improve concentration and attention in those with PD could potentially improve QoL. (C) 2016 The Authors. Published by Elsevier Ltd. This is an open access article under the CC. BY license (http://creativecommons.org/licenses/by/4.0/).
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