Objective: Cognitive impairment is linked to morbidity and mortality in patients with PD, this study aims to investigate whether the presence of constipation and RBD have an impact on future cognitive outcomes in PD.

Background: Constipation and RBD are the two earliest clincial signs of prodromal PD, while cognitive impairment is the most disabling non-motor symptom of patients with PD at late stage [1]. Among non-motor symptoms of PD, it is unclear whether constipation and RBD at early stages of PD are related to cognitive outcomes at later stages, although either of them has been shown associaton with cognitive decline later on [2,3].

Method: Access to PPMI database of 360 PD patients with longitudinal observation was requested. Constipation, probable RBD (pRBD) and neuropsychological task scores of all early PD patients were assessed at baseline and after 5 years. Bivariate analyses were conducted on demographic variables which might affect constipation, sleep and cognitive performance. Next, linear mixed-effects modelling, controlling for gender, age and years of education was used to evaluate the association between baseline constipation, pRBD and cognitive performance on follow-up.

Results: We found that men had worse neuropsychological test performances than women at early stages of PD, but did not differ in constipation and pRBD scores. The elderly had worse cognitive performanes and more constipation problem than the younger groups, but didn’t differ in pRBD among different age groups. In addition, we found constipation and pRBD are strongly associated with future decline in cognitive measures among PD patients, more prominently in men. Our data also showed that constipation was an independent cognitive performance predictor in young PD. While pRBD functioned more on cognitive prognosis in the middle aged or elderly PD, although pRBD and constipation could joint together impact on cognitive performances five years later in all PD patients.

Conclusion: Our data suggest that early assessment of pRBD and constipation in PD may allow better understanding of the prognosis of cognitive changes in later phases of the disease.

References: [1] Kalia LV & Lang AE, Parkinson’s disease，The Lancet. 2015;386:896-912 [2] Frazzitta G, et al. Severe Constipation in Parkinson’s Disease and in Parkinsonisms: Prevalence and Affecting Factors. Front Neurol. 2019; 10: 621. doi: 10.3389/fneur.2019.00621 [3] Haram A et al., Clinical Correlates of RBD in Early Parkinson Disease. J Alzheimers Dis Parkinsonism. 2014; 4:6 http://dx.doi.org/10.4172/2161-0460.1000174

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MDS Abstracts - https://www.mdsabstracts.org/abstract/baseline-predictors-of-constipation-and-probable-rapid-eye-movement-sleep-behavior-disorder-prbd-for-cognitive-impairment-after-5-years-of-parkinsons-disease-pd-diagnosis-in-the-parkinson/