Abstract Details

Title Evolution of Cognition in Mild-Moderate Parkinson's Disease

Topic Movement Disorders

Presentation(s) P12 - Poster Session 12 (12:00 PM-1:00 PM)

Poster/Presentation
Number 3-004

Objective To describe evolution of cognition in non-demented, independently living patients with Parkinson's disease (PD).

Background PD affects cognition and can lead to dementia.

Design/Methods Participants in driving studies at the University of Iowa underwent annual cognitive and motor testing over a 2 year interval. A composite measure of cognition (COGSTAT) was calculated by using standardized scores of eight tests from the cognitive test battery assessing different domains: Visual perception (Judgement of Line Orientation), visuospatial construction (Complex Figure Test [CFT]-Copy, Block Design), visual memory (Benton Visual Retention Test, CFT-Recall), verbal memory (Rey Auditory Verbal Learning Test), executive functions (Trail Making Test), and language (Controlled Oral Word Association).

Results A convenience sample of 101 independently living participants with PD (Median Hoehn-Yahr stage II, MMSE=28.1±1.8) and 140 normal comparison subjects were enrolled at baseline. At Year 1, 74.3% of patients with PD and 78.7% of comparison subjects returned for testing, whereas 55.4% of PD and 64.5% of comparisons returned for Year 2 assessment. The PD non-returnees for Year 2 had worse global cognition at Year 1 compared to returnees. Within the PD group, there was no significant worsening of UPDRS scores over 2 years. Cross-sectionally, PD patients performed worse than controls in all cognitive tests at all time points (p<0.001 to p<0.05). Longitudinal analyses (adjusted for age, sex, and education) showed that COGSTAT deteriorated more steeply in PD than comparison subjects over 2 years (p<0.01), which was primarily driven by steeper declines in Trail Making Test (p<0.05) and Block Design Test (p<0.001), especially between Years 1 and 2.

Conclusions Non-demented PD patients with mild-moderate disease severity showed significant decline in global cognition over 2 years, driven by changes in executive functions and visuospatial abilities that accelerated in the second year, suggesting 2 years as a potential duration for future clinical trials on cognitive impairment in PD.

Authors/Disclosures
Ergun Y. Uc, MD (University of Iowa) PRESENTER	An immediate family member of Dr. Uc has received personal compensation in the range of $500-$4,999 for serving as an officer or member of the Board of Directors for American Board of Pediatrics. The institution of Dr. Uc has received research support from Department of Veterans Affairs. The institution of Dr. Uc has received research support from Department of Defense. The institution of an immediate family member of Dr. Uc has received research support from NIH. The institution of Dr. Uc has received research support from NIH. The institution of Dr. Uc has received research support from NIH. The institution of Dr. Uc has received research support from Parkinson's Foundation. The institution of Dr. Uc has received research support from NIH.
Matthew Rizzo, MD, F�鶹��ýӳ�� (University of Nebraska Medical Center)	The institution of Dr. Rizzo has received research support from NIH.
Steven W. Anderson, PhD	Dr. Anderson has nothing to disclose.
Jeffrey Dawson	Jeffrey Dawson has received personal compensation in the range of $500-$4,999 for serving as a Consultant for iotaMotion. Jeffrey Dawson has received personal compensation in the range of $500-$4,999 for serving as an Editor, Associate Editor, or Editorial Advisory Board Member for Congress of Neurological Surgeons. The institution of Jeffrey Dawson has received research support from Department of Veterans Affairs. The institution of Jeffrey Dawson has received research support from NIH.

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