The akinetic-rigid (AR) subtype of Parkinson’s disease (PD), characterised by rigidity, akinesia and gait impairment, is associated with cognitive impairment unlike the tremor dominant (TD) subtype. It is unknown which symptoms in AR-PD drive this relationship, and whether individual symptoms are better predictors of cognitive impairment than motor subtype.
Methods Using a 100 item questionnaire, self-rated symptom severity data on PD-related symptoms sampled when the person signed up to the Parkinson’s UK Tissue Bank. Multivariate regression analysis was used to assess individual symptom scores as predictors of cognitive impairment severity, measured using composite scores of the cognitive symptom questionnaire items.
Results Gait disturbance was the only motor symptom predicting increasing cognitive impairment score (β=0.4025; p=0.0003). Additional significant predictors included: neuropsychiatric symptom score (β=0.2952; p=0.001), anosmia score (β=0.627; p=0.0004) and hallucination score (β=0.7586; p<0.0001).
Discussion Gait disturbance, hallucinations, neuropsychiatric symptoms and anosmia are associated with cognitive impairment in PD. Gait disturbance is unique among PD motor symptoms, in its relationship to cognitive impairment. Individual motor symptoms are of greater prognostic value than motor subtypes.
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