Objective: Dementia has now been noticed as a significant non-motor symptom of Parkinson’s disease (PD). We attempted to analyze the relation between the occurrence of dementia and the severity of the disease, and between the occurrence of dementia and the administered medicine.

Background: The Ministry of Health, Labour and Welfare (MHLW) of Japan has funded research programs to investigate etiology and treatment of intractable neurodegenerative diseases. Registered patients with PD (Hoehn & Yahr Stage 3-5) have been evaluated annually by the government. Since there was a revision in 2015 for “specified intractable disease” in Japan, it is impossible to carry out a follow-up survey among dementia in PD in our new system. Therefore we attempted to analyze the related factors of occurrence of dementia in PD using this program.

Methods: Objects were extracted from the application from 2010 to 2014 for PD provided by the specific diseases research program of MHLW of Japan. Patients diagnosed PD leastwise for one year, and not having dementia at the first evaluation were collected. Cox regression analysis was performed and a Kaplan-Meier curve was executed between the occurrence of dementia and the Hoehn & Yahr clinical severity classification, and between the occurrence of dementia and the administered medicine.

Results: There was 294183 incidents whose data for dementia was inputted in the form. Occurrence of dementia was highest in Hoehn & Yahr Stage 5, followed in order by Stage 4 and Stage 3 (p<0.0001). The similar occurrence was higher in patients who were administered L-dopa formulation than who were never administered L-dopa formulation (p<0.0013), whereas the similar occurrence was higher in patients who were administered dopamine receptor agonist in the past than in present (p<0.0001).

Conclusions: Occurrence of dementia was relevant with the clinical severity of PD. L-dopa formulation was speculated to have frequently administered to patients who progressed dementia, however administration of dopamine receptor agonist indicated the contrary. Our result may have been influenced by the Clinical Practice Guideline for PD published by the Japanese Society of Neurology. Further analysis is necessary to elucidate the relation between medication and occurrence of dementia in PD.

References: An investigation into the diagnoses, treatment, and hospital commutes in patients with advanced–stage Parkinson’s disease. Konaka et al, Neurological Therapeutics, 2016

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MDS Abstracts - https://www.mdsabstracts.org/abstract/analysis-of-related-factors-of-occurrence-of-dementia-in-parkinsons-disease-using-the-application-form-of-parkinsons-disease-provided-by-the-specific-diseases-treatment-research-prog/