Objective: To examine comorbidities associated with incident cognitive dysfunction in PD.

Background: The risk of dementia is up to six-times higher in PD compared to those without PD of similar age. The degree to which additional comorbidities increase the risk of PD cognitive dysfunction merits investigation. Our objective was to evaluate the association of vascular and nonvascular comorbidity history with incident cognitive dysfunction among people recently diagnosed with PD at baseline.

Method: Cox proportional hazards regression was used to examine the association of comorbidity history with PD cognitive dysfunction. Longitudinal data came from a combined dataset of STEADY-PD III, and SURE-PD 3 clinical trials, and the Parkinson’s Progression Marker Initiative observational study. Cognitive dysfunction was defined as a score of <= 21 on the Montreal Cognitive Assessment (MoCA) scale. Comorbidity history was captured from the Medical History Forms focusing on select vascular conditions (angina, heart disease, transient ischemic attack, dyslipidemia, hypertension, and diabetes) and nonvascular conditions (depression, arthritis, asthma/chronic obstructive pulmonary disease, and cancer). Models were adjusted for sociodemographic factors (sex, education, age at baseline) and baseline MoCA.

Results: Among the 870 PD participants with normal cognition (MoCA >= 26) at baseline, 57 (7%) developed cognitive dysfunction (MoCA <=21) over an average (SD) follow-up time of 3.8 (2.2) years.  When considering only vascular comorbidities, those with >= 2 vascular comorbidities were at increased risk of progression to cognitive dysfunction (hazard ratio (HR), 2.26 [95% CI 1.30 – 3.91]) compared to those with <= 1 vascular comorbidity. For nonvascular comorbidities, the risk was not significantly greater for those with >= 2 nonvascular comorbidities (HR, 1.18 [95% CI 0.59 – 2.36]) compared to those with <= 1. Considering both vascular and nonvascular comorbidities together, the risk was higher for those with >= 3 comorbidities (HR, 1.87 [95% CI 1.01 – 3.46]) but diminished for those with just >= 2 comorbidities (HR, 1.20 [95% CI 0.60 – 2.41]).

Conclusion: History of two or more comorbidities, particularly of vascular origin, is associated with higher hazard of developing cognitive dysfunction in PD.  Future analyses will incorporate additional comorbidity conditions and cognition endpoints.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/history-of-comorbidities-and-their-association-with-developing-cognitive-dysfunction-in-pd/