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Predictors of cognitive impairment in advanced Parkinson’s disease
  1. G Vingerhoets1,
  2. S Verleden1,
  3. P Santens2,
  4. M Miatton1,
  5. J De Reuck2
  1. 1Laboratory for Neuropsychology, Ghent University, Ghent, Belgium
  2. 2Department of Neurology, Ghent University Hospital
  1. Correspondence to:
 Dr Guy Vingerhoets, Laboratory for Neuropsychology, Ghent University, De Pintelaan 185 – 4K3, B-9000 Ghent, Belgium; 


Objective: To investigate the cognitive profile of patients with idiopathic Parkinson’s disease and to determine the demographic and medical variables that contribute to the cognitive outcome.

Design: Retrospective cohort analysis.

Methods: 100 patients with idiopathic Parkinson’s disease were given a neuropsychological test battery investigating attention, memory, and visuospatial and executive functions. Test performance was compared against normative data, and linear regression determined significant predictors of cognitive impairment from a set of demographic and disease course variables.

Results: Frontal-type cognitive dysfunction was widespread in patients with advanced Parkinson’s disease. Attention and memory were mildly to moderately impaired, whereas visuospatial function showed only subtle impairment. Older age and tremor at onset were significant predictors of poor cognitive performance.

Conclusions: The observed cognitive impairment in patients with advanced Parkinson’s disease is more than expected for normal aging. Although in apparent contrast with most previous research, reporting a greater risk of cognitive dysfunction in Parkinson’s disease patients with predominant akinesia/rigidity, tremor at onset may be a marker for more widespread brain pathology that contributes to an increased risk of cognitive impairment.

  • Parkinson’s disease
  • neuropsychology
  • cognitive impairment
  • AVLT, Rey auditory verbal learning test
  • BDI-C/A, cognitive/affective subscale of the Beck depression inventory
  • BVRT, Benton visual retention test
  • COWAT, controlled oral word association test
  • MRMT, Money’s standardised road map test
  • NART, national adult reading test
  • PPT, Purdue pegboard test
  • SCWT, Stroop coloured word test
  • UPDRS, unified Parkinson’s disease rating scale
  • VOSP, visual object and space perception battery
  • WCST, Wisconsin card sorting test

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  • Competing interests: none declared