Cognitive decline and quality of life in incident Parkinson's disease: The role of attention
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Author(s)
Lawson, Rachael A
Yarnall, Alison J
Duncan, Gordon W
Breen, David P
Khoo, Tien K
Williams-Gray, Caroline H
Barker, Roger A
Collerton, Daniel
Taylor, John-Paul
Burn, David J
Griffith University Author(s)
Year published
2016
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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 ¼ 212) completed a schedule of neuropsychological
assessments and QoL measures; these were repeated after 18 (n ¼ 190) and 36 months (n ¼ 158). Mild
cognitive impairment (PD-MCI) was classified ...
View more >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 ¼ 212) completed a schedule of neuropsychological assessments and QoL measures; these were repeated after 18 (n ¼ 190) and 36 months (n ¼ 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 (b ¼ 0.2, p < 0.01). For those subjects (9%) who developed dementia, cognitive function had a much greater impact on QoL (b ¼ 10.3, p < 0.05). Multivariate modelling showed attentional deficits had the strongest predictive power (b ¼ 2.3, p < 0.01); brief global tests only modestly predicted decline in QoL (b ¼ 0.4, p < 0.01). Conclusions: PD-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.
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View more >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 ¼ 212) completed a schedule of neuropsychological assessments and QoL measures; these were repeated after 18 (n ¼ 190) and 36 months (n ¼ 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 (b ¼ 0.2, p < 0.01). For those subjects (9%) who developed dementia, cognitive function had a much greater impact on QoL (b ¼ 10.3, p < 0.05). Multivariate modelling showed attentional deficits had the strongest predictive power (b ¼ 2.3, p < 0.01); brief global tests only modestly predicted decline in QoL (b ¼ 0.4, p < 0.01). Conclusions: PD-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.
View less >
Journal Title
Parkinsonism & Related Disorders
Volume
27
Copyright Statement
© 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/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Subject
Clinical sciences
Clinical sciences not elsewhere classified
Cognitive and computational psychology