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Impaired Cognition and the Risk of Parkinson Disease

Impaired Cognition and the Risk of Parkinson Disease Opinion EDITORIAL Trouble in Mind Ethan G. Brown, MD; Caroline M. Tanner, MD, PhD Parkinson disease (PD) is thought to develop gradually over significant risk factor for later development of parkinsonism and probable PD (hazard ratio [HR], 1.79; 95% CI, 1.37-2.33; and many years. As neurodegeneration begins and advances, an asymptomatic preclinical phase gives way to a prodromal syn- HR, 1.52; 95% CI, 1.10-2.08, respectively). The risk was still sig- drome, followed by clinically nificant beyond the first 8 years of follow-up and after adjust- manifested PD. Autonomic ment for subtle motor signs. However, when participants with dysfunction, hyposmia, mood subtle motor signs at baseline were removed from the analy- Related article disorder, and sleep disorder— sis, the association was no longer significant. Overall, cogni- particularly rapid eye movement sleep behavior disorder— tive impairment alone represented a likelihood ratio of 1.76 often precede clinical PD and are recognized prodromal (95% CI, 1.23-2.51) for development of parkinsonism, while cog- features. Intervention in the prodromal stage may stop the nitive impairment with subtle motor findings was 2.66 (95% neurodegenerative process before PD is fully manifest. Early CI, 1.64-4.32). and accurate identification of prodromal PD before neurode- Three other prospective cohorts have http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png JAMA Neurology American Medical Association

Impaired Cognition and the Risk of Parkinson Disease

JAMA Neurology , Volume 74 (12) – Dec 25, 2017

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Publisher
American Medical Association
Copyright
Copyright 2017 American Medical Association. All Rights Reserved.
ISSN
2168-6149
eISSN
2168-6157
DOI
10.1001/jamaneurol.2017.1474
Publisher site
See Article on Publisher Site

Abstract

Opinion EDITORIAL Trouble in Mind Ethan G. Brown, MD; Caroline M. Tanner, MD, PhD Parkinson disease (PD) is thought to develop gradually over significant risk factor for later development of parkinsonism and probable PD (hazard ratio [HR], 1.79; 95% CI, 1.37-2.33; and many years. As neurodegeneration begins and advances, an asymptomatic preclinical phase gives way to a prodromal syn- HR, 1.52; 95% CI, 1.10-2.08, respectively). The risk was still sig- drome, followed by clinically nificant beyond the first 8 years of follow-up and after adjust- manifested PD. Autonomic ment for subtle motor signs. However, when participants with dysfunction, hyposmia, mood subtle motor signs at baseline were removed from the analy- Related article disorder, and sleep disorder— sis, the association was no longer significant. Overall, cogni- particularly rapid eye movement sleep behavior disorder— tive impairment alone represented a likelihood ratio of 1.76 often precede clinical PD and are recognized prodromal (95% CI, 1.23-2.51) for development of parkinsonism, while cog- features. Intervention in the prodromal stage may stop the nitive impairment with subtle motor findings was 2.66 (95% neurodegenerative process before PD is fully manifest. Early CI, 1.64-4.32). and accurate identification of prodromal PD before neurode- Three other prospective cohorts have

Journal

JAMA NeurologyAmerican Medical Association

Published: Dec 25, 2017

References