Cargando…

The incidence, baseline predictors, and outcomes of dementia in an incident cohort of Parkinson’s disease and controls

BACKGROUND: There are few long-term data on the incidence, baseline predictors, and outcomes of dementia in Parkinson’s disease (PD) from prospective community-based incident cohorts. METHODS: The PINE study prospectively identified all incident PD patients in Aberdeen along with age–sex-matched, co...

Descripción completa

Detalles Bibliográficos
Autores principales: Counsell, Carl, Giuntoli, Cinzia, Khan, Qaisar Imran, Maple-Grødem, Jodi, Macleod, Angus D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Berlin Heidelberg 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9294013/
https://www.ncbi.nlm.nih.gov/pubmed/35307754
http://dx.doi.org/10.1007/s00415-022-11058-2
_version_ 1784749764809588736
author Counsell, Carl
Giuntoli, Cinzia
Khan, Qaisar Imran
Maple-Grødem, Jodi
Macleod, Angus D.
author_facet Counsell, Carl
Giuntoli, Cinzia
Khan, Qaisar Imran
Maple-Grødem, Jodi
Macleod, Angus D.
author_sort Counsell, Carl
collection PubMed
description BACKGROUND: There are few long-term data on the incidence, baseline predictors, and outcomes of dementia in Parkinson’s disease (PD) from prospective community-based incident cohorts. METHODS: The PINE study prospectively identified all incident PD patients in Aberdeen along with age–sex-matched, community-based controls who consented to standardized annual life-long follow-up. Each year, a clinical expert reviewed the diagnosis of PD and the presence of dementia according to DSM-IV-based criteria. Age–sex stratified incidence rates for dementia in PD and controls were calculated and compared with hazard ratios (HR) adjusted for age, sex, education, and socioeconomic status. Cox proportional-hazard modelling was used to assess baseline predictors for PD dementia and the influence of dementia on survival and institutionalization. RESULTS: 201 patients (mean age 72.6yrs) and 260 controls (mean age 75.4yrs) were followed for median 9.5 years. The incidence of dementia was 7.4 (PD) versus 2.1 (controls) per 100 person-years (adjusted HR 6.0, 95%CI 4.1–8.7), with a sixfold increase from under 60 to over 80 years in PD but no sex difference. Independent baseline predictors of PD dementia were older age at diagnosis, self-reported cognitive symptoms, dream enactment, lower MMSE scores, worse motor UPDRS scores, and the ApoE genotype. PD dementia increased the rates of subsequent death and institutionalization (32.0 and 26.9 per 100 person-years, respectively). CONCLUSION: The incidence of dementia in PD is high, increases markedly with age, is increased in those with baseline subjective cognitive symptoms as well as other established risk factors, and is associated with high rates of death and institutionalization. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-022-11058-2.
format Online
Article
Text
id pubmed-9294013
institution National Center for Biotechnology Information
language English
publishDate 2022
publisher Springer Berlin Heidelberg
record_format MEDLINE/PubMed
spelling pubmed-92940132022-07-20 The incidence, baseline predictors, and outcomes of dementia in an incident cohort of Parkinson’s disease and controls Counsell, Carl Giuntoli, Cinzia Khan, Qaisar Imran Maple-Grødem, Jodi Macleod, Angus D. J Neurol Original Communication BACKGROUND: There are few long-term data on the incidence, baseline predictors, and outcomes of dementia in Parkinson’s disease (PD) from prospective community-based incident cohorts. METHODS: The PINE study prospectively identified all incident PD patients in Aberdeen along with age–sex-matched, community-based controls who consented to standardized annual life-long follow-up. Each year, a clinical expert reviewed the diagnosis of PD and the presence of dementia according to DSM-IV-based criteria. Age–sex stratified incidence rates for dementia in PD and controls were calculated and compared with hazard ratios (HR) adjusted for age, sex, education, and socioeconomic status. Cox proportional-hazard modelling was used to assess baseline predictors for PD dementia and the influence of dementia on survival and institutionalization. RESULTS: 201 patients (mean age 72.6yrs) and 260 controls (mean age 75.4yrs) were followed for median 9.5 years. The incidence of dementia was 7.4 (PD) versus 2.1 (controls) per 100 person-years (adjusted HR 6.0, 95%CI 4.1–8.7), with a sixfold increase from under 60 to over 80 years in PD but no sex difference. Independent baseline predictors of PD dementia were older age at diagnosis, self-reported cognitive symptoms, dream enactment, lower MMSE scores, worse motor UPDRS scores, and the ApoE genotype. PD dementia increased the rates of subsequent death and institutionalization (32.0 and 26.9 per 100 person-years, respectively). CONCLUSION: The incidence of dementia in PD is high, increases markedly with age, is increased in those with baseline subjective cognitive symptoms as well as other established risk factors, and is associated with high rates of death and institutionalization. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s00415-022-11058-2. Springer Berlin Heidelberg 2022-03-21 2022 /pmc/articles/PMC9294013/ /pubmed/35307754 http://dx.doi.org/10.1007/s00415-022-11058-2 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Original Communication
Counsell, Carl
Giuntoli, Cinzia
Khan, Qaisar Imran
Maple-Grødem, Jodi
Macleod, Angus D.
The incidence, baseline predictors, and outcomes of dementia in an incident cohort of Parkinson’s disease and controls
title The incidence, baseline predictors, and outcomes of dementia in an incident cohort of Parkinson’s disease and controls
title_full The incidence, baseline predictors, and outcomes of dementia in an incident cohort of Parkinson’s disease and controls
title_fullStr The incidence, baseline predictors, and outcomes of dementia in an incident cohort of Parkinson’s disease and controls
title_full_unstemmed The incidence, baseline predictors, and outcomes of dementia in an incident cohort of Parkinson’s disease and controls
title_short The incidence, baseline predictors, and outcomes of dementia in an incident cohort of Parkinson’s disease and controls
title_sort incidence, baseline predictors, and outcomes of dementia in an incident cohort of parkinson’s disease and controls
topic Original Communication
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9294013/
https://www.ncbi.nlm.nih.gov/pubmed/35307754
http://dx.doi.org/10.1007/s00415-022-11058-2
work_keys_str_mv AT counsellcarl theincidencebaselinepredictorsandoutcomesofdementiainanincidentcohortofparkinsonsdiseaseandcontrols
AT giuntolicinzia theincidencebaselinepredictorsandoutcomesofdementiainanincidentcohortofparkinsonsdiseaseandcontrols
AT khanqaisarimran theincidencebaselinepredictorsandoutcomesofdementiainanincidentcohortofparkinsonsdiseaseandcontrols
AT maplegrødemjodi theincidencebaselinepredictorsandoutcomesofdementiainanincidentcohortofparkinsonsdiseaseandcontrols
AT macleodangusd theincidencebaselinepredictorsandoutcomesofdementiainanincidentcohortofparkinsonsdiseaseandcontrols
AT counsellcarl incidencebaselinepredictorsandoutcomesofdementiainanincidentcohortofparkinsonsdiseaseandcontrols
AT giuntolicinzia incidencebaselinepredictorsandoutcomesofdementiainanincidentcohortofparkinsonsdiseaseandcontrols
AT khanqaisarimran incidencebaselinepredictorsandoutcomesofdementiainanincidentcohortofparkinsonsdiseaseandcontrols
AT maplegrødemjodi incidencebaselinepredictorsandoutcomesofdementiainanincidentcohortofparkinsonsdiseaseandcontrols
AT macleodangusd incidencebaselinepredictorsandoutcomesofdementiainanincidentcohortofparkinsonsdiseaseandcontrols