Dementia Registry for Parkinson's Disease
Condition: Dementia; Parkinson's Disease
MeSH terms: Parkinson Disease; Dementia
Study type: Observational

Summary: 
      Background

      Cognitive impairment in Parkinson's disease (PD) is common, even in the early stage of this
      disease.The cumulative prevalence of dementia associated with Parkinson's disease (PDD) is as
      high as 80% in a recent 8-year prospective study. However, some kinds of cognitive impairment
      are not apparent and the value of self-report cognitive decline became limited. In other
      words, some cognitive impairment may be detected by cognitive tests rather than self-report
      of the symptoms.The early intervention of the cognitive impairment may be helpful for these
      patients. Neuropsychiatric symptoms(NPSs) are also common in PD and PDD patients. The
      severity of NPSs contributes to reduced quality of life and distress for caregivers. Previous
      studies showed some different clinical phenotypes of NPSs in PD or PDD patients. Among the
      NPSs, hallucination was considered a critical factor of cognitive dysfunction in PD and PDD
      patients. The co-occurrence of NPSs in PD and PDD patients has limited evidence now.

      Purpose

      To establish the screening tools for early detecting the PD patient with cognitive
      impairment; exam the diagnostic value of MoCA and other cognitive tests in PD with mild
      cognitive impairment, possible PDD, and probable PDD; understand neuropsychiatric symptoms
      (NPSs) in these different patient groups; exam the relationship between each NPS and each
      domain of cognitive dysfunction.

      Methods

      In order to exam the cognitive dysfunction in PDD (attention, executive function,
      visuo-spatial function, and memory), several tests are performed. A 32-item cognitive decline
      questionnaire will be used to screen the cognitive impairment in subjects. Mini-Mental state
      examination (MMSE) and Montreal cognitive assessment (MoCA)are used for cognitive evaluation.
      The detail evaluation of each domain is specified asfollowing: (1) Attention (WAIS-R digit
      span), (2) Memory (12-item word recall test),(3) Executive function (category verbal
      fluency), (4) Visuospatial function (cube copying and clock drawing). The motor symptoms
      severity of the PD will be evaluated by the Hoehn & Yahr stage and motor portion of the
      Unified Parkinson's Disease Rating Scale (UPDRS). The neuropsychiatric symptoms will be
      recorded by Neuropsychiatric Inventory Questionnaire (NPI-Q). The daily living activity will
      beevaluated by modified Lawton's instrumental activities of daily living scale (IADL)and pill
      questionnaire. Subjects also receive 15-item Geriatric Depression Scale(GDS-S) to evaluate
      the mood status. The clinician's diagnosis of dementia will be based on the diagnostic
      criteria of DSM-IV, which will be compared with the PDDdiagnostic criteria proposed by MDS in
      2007. The investigators will also try to develop a PDDscreening questionnaire.

      Expected results

      Cognitive impairment and dementia of PD patients will be ascertained by the cognitive test
      battery. The screening questionnaire will be established. The heterogeneity of NPSs in PD and
      PDD will be evaluated. The PDD screening questionnaire will help the clinician to diagnose
      the patients.
    


Observational model: Case-Control
Time perspective: Prospective
Sampling method: Non-Probability Sample
Study population: 
        Parkinson's Disease patients.
      
Keywords: Dementia; Parkinson's; impairment; Dementia Registry for Parkinson's Disease