D Aarsland

..In addition, there is a need for studies of whether potentially disease-modifying agents can prevent or delay the progression to dementia in PD...

..This Review describes the frequency and course of depression in patients with PD. The mechanisms that underlie depression in this disease are also discussed, and the management strategies for these patients are highlighted...

..The genetic contributions to dementia are currently not clear and need to be explored in future studies...

..PD-MCI predicts a shorter time to dementia, and preliminary evidence suggests that this is particularly true for posterior cognitive deficits. There are currently no systematic clinical trials in PD-MCI...

..This inflection point was estimated to occur 13.3 years (95% credible interval 11.8, 13.6) after the diagnosis of PD; however, there were wide interindividual variations in the time from onset of PD to the inflection point...

..In studies of mild cognitive impairment (MCI) in Parkinson disease (PD), patients without dementia have reported variable prevalences and profiles of MCI, likely to be due to methodologic differences between the studies...

..Our aim was to identify biomarkers that may differentiate DLB from Alzheimer's disease (AD)...

..The purpose of this review is to present recent findings on clinical aspects of dementia in PD and to elucidate underlying clinical and neurobiological risk factors...

..Although several studies of potential risk factors for vascular dementia (VaD) exist, including physical activity, the studies have usually included few participants and there are no meta-analyses addressing this key topic...

..There is thus an urgent need for systematic studies for the pharmacological and non-pharmacological management of these symptoms...

..Neuropsychiatric symptoms are common in Parkinson's disease (PD) and have important clinical consequences for patients, caregivers and society. Few studies of neuropsychiatric symptoms in early untreated PD exist...

..To examine the occurrence and clinical and demographic correlates of REM sleep behaviour disorder (RBD) in patients with Parkinson's disease (PD) in a community-based cohort over 8 years...

..To compare neuropsychiatric symptoms in patients with Alzheimer's disease (AD) and dementia with Lewy bodies(DLB)...

..To explore the profile of neuropsychiatric symptoms in patients with dementia associated with Parkinson's disease (PDD)...

..The aim of this study was to explore the proportion with mild cognitive impairment (MCI) and subtypes in an incidence cohort of untreated PD in Southern and Western Norway...

..However, the absolute risk of dementia and how it affects survival in PD are not known. Such questions are important for patients, their families, and service providers but require long-term studies...

..The objective of this study was to describe the range of neuropsychiatric symptoms in a representative sample of patients with Parkinson's disease...

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..To examine associated demographic and clinical correlates and the development of excessive daytime sleepiness (EDS) over 8 years in a community-based cohort of patients with Parkinson disease (PD)...

..The relation between dementia with Lewy bodies (DLB) and Parkinson's disease with dementia (PDD) is unknown...

..To investigate the inter-relationship of neuropsychiatric disturbances in Parkinson's disease (PD) by cluster analysis and describe the properties of the clusters...

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..International comparative studies offer special advantages in elucidating environmental risk factors by providing a wider diversity of environmental exposures such as nursing home structures, health care systems and genetic diversity...

..We investigated caregiver distress associated with neuropsychiatric problems in patients with newly diagnosed Parkinson's disease (PD)...

..To compare the frequency and clinical correlates of neuropsychiatric symptoms in patients with Parkinson's disease (PD) with and without dementia and in those with dementia with Lewy bodies (DLB)...

..To calculate the incidence of and determine possible risk factors for dementia in PD...

..However, the prevalence and clinical features of these symptoms have not been studied in a representative sample...

..Six subjects (29%) discontinued treatment prematurely because of drowsiness. Delusions and hallucinations improved significantly, and 80% were rated as much or very much improved. There was no worsening of parkinsonism or cognition...

..Apathy is a common but under-recognised behavioural disorder associated with depression and cognitive impairment in patients with Parkinson disease (PD). However, the longitudinal course of apathy in PD has not been studied...

..The association between apathy and intrusions supports the hypothesis that lesions in frontal areas or frontal connections contribute to a specific neuropsychiatric syndrome in patients with MS...

..To investigate the effects of attentional deficits on activities of daily living (ADL) in patients with dementia associated with Parkinson's disease (PDD)...

..The aim of this study is to investigate the association of psychosocial factors and patient factors with stress in care staff in nursing homes...

..However, age at onset (AAO) and age at baseline assessment are often correlated. The aim of this study was to explore whether AAO of PD symptoms is a risk factor for dementia independent of the general effect of age...

..To examine the development of nocturnal sleeping problems in patients with Parkinson's disease (PD) over an 8-year period and to study the clinical and demographic correlates of insomnia...

..Severity of EPS correlated with age, duration of disease, and cognitive impairment in PD patients but not in DLB patients. Studies of the clinical significance and management of EPS in DLB patients are needed...

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..To determine the emotional and social distress of caring for a patient with Parkinson's disease and to explore the impact of motor and mental symptoms in subjects with Parkinson's disease on their caregivers' situation...

..We studied the level of distress in caregivers of patients with recently diagnosed multiple sclerosis (MS), and their relation to clinical characteristics...

..CONCLUSIONS: An operationalized evaluation of severe NSR blind to diagnosis confirmed the high prevalence in DLB and identified high frequencies in Parkinson's disease and PDD with important implications for clinical practice...

..Future studies should explore the longitudinal effect of dopamine replacement therapy on apathetic behaviour in early PD. The relationship between apathy and male gender needs further study to be fully evaluated...

..To investigate risk factors and the rate of progression of motor symptoms and disability in a population-based cohort of patients with Parkinson disease (PD)...

..These findings suggest that in some patients with PDD, frontosubcortical changes are the main contributing factor to dementia, whereas in other patients, cortical and hippocampal changes are more important...

..During follow-up, 30 new patients had EDS (6% new patients per year). In 1997, 29% of the patients with PD had EDS. The development of EDS correlated with more advanced disease and dementia...

..Our results indicate that the familial aggregation of the disease is independent of the age of the proband...

..Such knowledge would provide opportunities to prevent acceleration of cognitive decline in PD...

..To find the proportion of dementia with Lewy bodies (DLB) in a referral cohort of patients with a first-time diagnosis of mild dementia...

..Identification of mild cognitive impairment is important, since these symptoms are important for patient management and may also facilitate to determine prognosis...

..However, these findings should be interpreted with caution due to the relatively small number of subjects included in this study...

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..This finding may have important clinical implications as a marker of subsequent development of dementia...

..The authors investigated whether AD-related CSF protein levels are altered and relate to neuropsychological performance in early, untreated PD...

..The objective of this study was to compare the cognitive profile of hallucinating vs. nonhallucinating patients with Parkinson's disease dementia (PDD)...

..To identify sleep disturbances in participants with subtypes of dementia and explore clinical correlates...

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..The aim of this study was to determine whether an education and supervision intervention could reduce agitation and the use of restraints and antipsychotic drugs in nursing homes...

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..This study strongly suggests that Lewy body disease is the main substrate driving the progression of cognitive impairment in Parkinson's disease...

..4%; P = .03). No significant associations between the Apolipoprotein E genotype and development and progression of dementia or time to dementia were found. More studies with larger Parkinson disease samples are warranted...

..To investigate the prevalence, incidence, risk factors, and concomitants of Parkinson disease (PD)-associated psychosis (PDP) in a population-based prevalent cohort...

..We conducted a study using voxel-based morphometry (VBM) to explore the pattern of cortical atrophy in DLB and PDD...

..66-0.69). Covariates of this factor were identified using structural equation modeling (SEM) by regression on patient's age, gender, cognitive function (MMSE), activities of daily living (ADL) and depressive symptoms (MADRS)...

..To compare the profile of cognitive impairment in Alzheimer's disease (AD) with dementia associated with Parkinson's disease (PDD)...

..The estimated prevalence of PDD in the general population aged 65 years and over is 0.2 to 0.5%...

..This hypothesis has been challenged by new data. We have therefore investigated verbal memory and learning in a large sample of newly diagnosed, drug naïve, non-demented patients with PD...

..To study the safety and efficacy of the cholinesterase inhibitor donepezil in patients with Parkinson's disease (PD) and cognitive impairment...

..Our results indicate that the early development of dementia in PD is associated with more severe degeneration of cortical and sub-cortical structures...

..01) than SLE patients. CONCLUSION: Neuropsychiatric symptoms occur frequently in patients with MS. Irritability and apathy are independent of disability and chronic disease and represent unique disease manifestations...

..Orthostatic hypotension (OH) and QTc prolongation have potentially important prognostic and therapeutic consequences but have rarely been studied in patients with mild dementia...

..Our findings suggest that WMH in the deep white matter may contribute to dementia in PD...

..Although some placebo-controlled trials have been published recently, no established treatments are currently available for these symptoms (85) (see Table 5-2), and thus future clinical trials are needed...

..Serotonin 1A receptors (5-HT(1A)) have not been studied in dementia with Lewy bodies (DLB) or Parkinson's disease dementia (PDD) patients with depression...

..More studies are needed to clarify the role of cholinergic and other psychotropic agents as well as nonpharmacologic interventions for psychiatric and behavioral symptoms in patients with dementia...

..CONCLUSION: The profile of depressive symptoms in PD differs from that in depressed subjects without PD. This finding is important for the conceptualisation and clinical diagnosis of depression in PD...

..The authors examined the relationship between pain and depression in a community-based sample of patients with PD...

..Dementia is common in Parkinson's disease, but the underlying brain pathology is not yet fully understood...

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..We aimed to test the safety and efficacy of the N-methyl D-aspartate (NMDA) receptor antagonist memantine in patients with PDD or DLB...

..There is emerging evidence that treatment of cardiovascular disease and risk-factors can reduce the risk for late-life depression, but more studies are needed to test this hypothesis...

..The objective of this study was to explore the load of white matter hyperintensities (WMH) in patients with Lewy body dementia (LBD) and compare to Alzheimer's disease (AD) and normal controls (NC)...

..Few longitudinal studies of dementia in Parkinson disease (PD) have been reported, and the proportion of patients with PD who eventually develop dementia is unknown...

..These findings raise the question whether PIGD and dementia share common or parallel neuropathology...

..Alzheimer's disease (AD) and dementia with Lewy bodies (DLB) are the most common neurodegenerative dementia types. It is important to differentiate between them because of the differences in prognosis and treatment approaches...

..Use of restraint amongst institutionalised elderly with dementia and problem behaviour not only remains widespread, but also appears to be accepted as inevitable...

..A score of 2 or more on the motivation/initiative item was adequate to screen for apathy, whereas a score of 4 had high diagnostic accuracy at the cost of unacceptable low sensitivity...

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..Although CSF markers such as amyloid β42 (Aβ42) and P-tau can distinguish between AD and normal controls, their ability to distinguish between AD and DLB is not adequate...

..Dementia with Lewy bodies (DLB) is a common form of late-life dementia that can be difficult to differentiate from other disorders, especially Alzheimer disease (AD), during life. At autopsy the striatal dopaminergic transporter is reduced...

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..Clear guidance on the management of DLB is urgently needed. Virtually unrecognised 20 years ago, DLB could within this decade be one of the most treatable neurodegenerative disorders of late life...

..However, the marked cognitive decline in 2 patients carrying intermediate-size alleles points to a possible association. More studies with larger PD samples are warranted...

..These criteria require validation and may be refined, but form a starting point for studies of the epidemiology and pathophysiology of PDPsy, and are a potential indication for therapy development...

..Psychosis, agitation, apathy and depression were assessed using standardised measures in 32 patients with mild Alzheimer's disease...

..Based on the characteristic features associated with this condition, clinical diagnostic criteria for probable and possible PD-D are proposed...

..Visual hallucinations appear to predict more rapid decline and possibly greater therapeutic benefit from rivastigmine treatment in PDD...

..Non-pharmacological interventions can also be effective but require further study...

..Further studies with larger samples are needed to explore a possible relationship between a family history of PD and development of dementia in PD and its potential pathogenetic mechanisms...

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..There is a convincing genetic overlap between both syndromes, suggesting that they share a common etiological factor...