Session Information
Date: Wednesday, June 22, 2016
Session Title: Parkinson's disease: Cognition
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: To evaluate the correlation between cognitive and functional performance of Parkinsonian with normal Mini-Mental State Examination (MMSE), and demographic variables, motor impairment, neuropsychiatric disorders and medications.
Background: Many factors have been associated with cognitive performance of Parkinsonian without dementia mainly hallucinations, REM sleep behavioral disorders, apathy, depression, age, education, motor impairment, motor subtype and dysautonomia. Nevertheless, few authors have studied the cognitive effect of medications used by Parkinson’s disease patients.
Methods: We studied 43 Parkinsonian with normal MMSE considering brazilian education cut-offs. We performed simple and multiple linear regressions using Montreal Cognitive Assessment (MoCA) score as dependent variable and age, education, UPDRS-part III, Hoehn and Yhard Scale (HY), motor subtype, Apathy Scale, Hospital Depression and Anxiety Scale (HADS), hallucination sub-item of Neuropsychiatric Inventory and medications (L-dopa equivalent dose, benzodiazepines, antidepressants, anticholinergics and antipsychotics) as independent variables. We also performed simple and multiple logistic regressions using an adapted version of Disability Assessment for Dementia Scale (a scale measuring any dependence on other for daily living activities stemmed from cognitive impairment) as dependent variable and the same as in linear regression as independent variables. The variables on simple regressions with p<0.1 were chosen for multiple regression. The Akaike information criterion was used to estimate the model that best explained the dependent variables. We considered significant p<0.05.
Results: Sample characteristics are presented in table 1. The best multiple linear model explaining MoCA score included (table 2): benzodiazepine use (p=0.004), hallucinations (p=0.127), depression items score of HADS (p= 0.054) and HY (p=0.151). The best multiple logistic model explaining dependence for activities of daily living included (table 2): benzodiazepine use (p=0.006), hallucinations (p=0.104), depression items score of HADS (p=0.320), HY (p=0.184), and motor subtype (p=0.094).
Conclusions: In this study the use of benzodiazepines was the only factor correlated significantly with cognitive and functional performance of Parkinsonian with normal MMSE.
| Characteristics | Mean (standard deviation) | Frequency (absolute number) |
| Age, years | 63,6 (8,2) | – |
| Education, years | 10,5 (4,2) | – |
| Gender, male | – | 65,1% (28) |
| Disease duration, years | 11,1 (4,6) | – |
| UPDRS-part III, score | 22,6 (10,7) | – |
| Hoehn and Yahr stage I | – | 14% (6) |
| Hoehn and Yahr stage II | – | 58,1% (25) |
| Hoehn and Yahr stage III | – | 23,3% (10) |
| Hoehn and Yahr stage IV | – | 4,7% (2) |
| Tremor dominant subtype | – | 27,9% (12) |
| Postural stability and gait difficult dominant subtype | – | 72,1% (31) |
| Hallucination (Neuropsychiatric Inventory) | – | 16,3% (7) |
| Hospital Depression and Anxiety scale, depression score | 6 (2,9) | – |
| Hospital Depression and Anxiety scale, anxiety score | 6,8 (3,5) | – |
| Apathy Scale, score | 7,9 (6,9) | – |
| L-dopa equivalent dose | 979,5 (400,7) | – |
| Anticholinergic use | – | 18,6% (8) |
| Benzodiazepine use | – | 37,2% (16) |
| Antidepressant use | – | 32,6% (14) |
| Antipsychotic use | – | 14% (6) |
| Mini-mental State Examination, score | 27,3 (1,6) | – |
| Montreal Cognitive Assessment, score | 24,4 (2,97) | – |
| Independent variables | Simple linear regression (p value)* | Multiple linear regression (p value)* | Multiple linear regression (B coefficient)* | Simple logistic regression (p value)[sect] | Multiple logistic regression (p value)[sect] | Multiple Logistic Regression (Odds Ratio)[sect] |
| Age, years | 0.02 | – | – | 0.02 | – | – |
| Education, years | 0.12 | – | – | 0.17 | – | – |
| UPDRS-part III, score | 0.38 | – | – | 0.06 | – | – |
| Hoehn and Yhar ± | 0.02 | 0.15 | -1.32 | 0.01 | 0.18 | 2.77 |
| Motor subtyping [para] | 0.11 | – | – | 0,08 | 0.09 | 33.11 |
| Hospital Depression and Anxiety scale, depression score | 0.005 | 0.05 | -0.27 | 0.06 | 0.32 | 1.21 |
| Hospital Depression and Anxiety scale, anxiety score | 0.35 | – | – | 0.29 | – | – |
| Apathy Scale, score | 0.23 | – | – | 0.04 | – | – |
| Hallucinations (Neuropsychiatric Inventory) | 0.01 | 0.13 | -1.73 | 0.01 | 0.10 | 11.12 |
| L-dopa equivalent dose | 0.32 | – | 0.62 | – | – | |
| Benzodiazepine use | 0.001 | 0.004** | -2.40 | 0.001 | 0.006** | 90.09 |
| Anticholinergic use | 0.22 | – | – | 0.99 | – | – |
| Antidepressant use | 0.29 | – | – | 0.58 | – | – |
| Antipsychotic use | 0.20 | – | – | 0.85 | – | – |
To cite this abstract in AMA style:
R. Breder, M.A.A. Leite, M.C.A. Ribas, M. Orsini. Analysis of factors associated with cognitive and functional performance in Parkinsonian with normal mini-mental state examination [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/analysis-of-factors-associated-with-cognitive-and-functional-performance-in-parkinsonian-with-normal-mini-mental-state-examination/. Accessed November 22, 2024.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/analysis-of-factors-associated-with-cognitive-and-functional-performance-in-parkinsonian-with-normal-mini-mental-state-examination/