Objective: To assess the relationship between the presence of Rapid eye movement  sleep and behavior disorders RBD and the cognitive decline of non-demented patients with PD in 3 year follow-up study.

Background: Rapid eye movement sleep behavior disorder (RBD) is often present in Parkinson’ s disease. In numerous cross-sectional studies, PD patients with RBD (PD_RBD+) have increased cognitive impairment on neuropsychological testing, but fewer prospective studies have assessed whether RBD can predict Parkinson’s disease cogniotive decline.

Methods: Two hundred and fourty seven Parkinson’s disease patients aged 45–75 years were screened positive for probable RBD using the Mayo Sleep Questionnaire. The patients were followed annually at 36 month period with a comprehensive spectrum of motor and non-motor scales (motor severity, motor complications, motor subtypes, quantitative motor tests, autonomic and psychiatric manifestations, olfaction, sleep parameters, and neurocognitive testing). In a Cox Proportional Hazards Model, we measured the risk of developing MCI, dementia, in (PD_RBD+) and (PD_RBD−) subgroups.

Results: At baseline 90 had RBD and 157 did not. PD patients with RBD were older (P = 0.034) and were more likely to be male (P < 0.001). In addition, there was a probable relationship between RBD and non-tremor predominant subtype of PD (P = 0.04), increased frequency of falls (P = 0.009), and depression (P = 0.009) and cognitive impairment (p= 0.005).  Further in the 3 year follow-up, after adjustment for age, sex, education, and medical comorbidity, PB_RBD+ subjects were at increased risk of MCI in PD (p= 0.005).  MCI was found in 53% PD_RBD+ and in 17% PD_RBD-.  Duration of RBD symptoms did not predict the development of MCI in PD. PD _RBD+ also performed worse than PD_RBD-patients on neuropsychological tests assessing visuo-constructional and visuo-perceptual abilities

Conclusions: Our results support previous findings that RBD is a multifaceted phenomenon in PD. Patients with PD who have RBD tend to have specific motor and non-motor manifestations, especially cognitive impairment. The presence of RBD might suggested an increased risk of incident MCI and dementia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/rbd-predicts-the-cognitive-impairment-in-parkinsons-disease/