scholarly journals Low-dose anticholinergic therapy causes cognitive impairment in Parkinson's disease patients

2021 ◽  
Vol 64 (4) ◽  
pp. 66-68
Author(s):  
Olga Gavriliuc ◽  
◽  
Alexandru Andrusca ◽  
Lilian Popil ◽  
Mihail Gavriliuc ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Performance ◽  
Low Income ◽  
Low Dose ◽  
Disease Duration ◽  
Cognitive Status ◽  
Low Income Countries ◽  
Anticholinergic Drugs ◽  
Average Dose

Background: Before L-Dopa’s discovery, anticholinergic drugs were among the first treatments for Parkinson’s disease. Only now trihexyphenidyl (THP) is approved to treat unresponsive L-dopa tremors in young, cognitively unaffected Parkinson’s disease patients. However, there are no specific recommendations for disease duration, medication dose, or cognitive status. In low-income countries, THP is still frequently used in Parkinson’s disease patients with tremor. The objective of the current study was to evaluate cognitive performance in Parkinson’s disease patients receiving a low dose of THP. Material and methods: The study was performed on nineteen PD patients, nine of whom were on THP. All patients completed MoCA cognitive assessment. The patients were matched depending on their age, disease severity based on UPDRS III and duration of the disease. Results: The THP patients were taking an average dose of 3.3 mg of THP daily for an average of 1.8 years. There were no statistical differences between THP patients and non-THP patients in age (64.8± 4.8 vs 67.2±6.9, p=0.4), UPDRS III (32.1±8.9 vs 41.5±20.6, p=0.2) and disease duration (6.2±4.9 vs 7.0 ± 4.0, p=0.7). The THP patients had lower cognitive performance, with a total MoCA of 19.22 ± 3.3 vs. non-THP patients 24.2±3.0, p=0.003. Conclusions: In Parkinson’s disease patients, even a low dose of THP causes significant cognitive loss.

scholarly journals Elevated HDL Levels Linked to Poorer Cognitive Ability in Females With Parkinson’s Disease

2021 ◽  
Vol 13 ◽  
Author(s):  
Megan C. Bakeberg ◽  
Anastazja M. Gorecki ◽  
Jade E. Kenna ◽  
Alexa Jefferson ◽  
Michelle Byrnes ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cognitive Function ◽  
Cognitive Performance ◽  
Linear Models ◽  
Low Density Lipoprotein ◽  
Density Lipoprotein ◽  
Cognitive Status ◽  
Cross Sectional ◽  
Age Related

IntroductionCholesterol levels have been associated with age-related cognitive decline, however, such an association has not been comprehensively explored in people with Parkinson’s disease (PD). To address this uncertainty, the current cross-sectional study examined the cholesterol profile and cognitive performance in a cohort of PD patients.MethodsCognitive function was evaluated using two validated assessments (ACE-R and SCOPA-COG) in 182 people with PD from the Australian Parkinson’s Disease Registry. Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and Triglyceride (TRG) levels were examined within this cohort. The influence of individual lipid subfractions on domain-specific cognitive performance was investigated using covariate-adjusted generalised linear models.ResultsFemales with PD exhibited significantly higher lipid subfraction levels (TC, HDL, and LDL) when compared to male counterparts. While accounting for covariates, HDL levels were strongly associated with poorer performance across multiple cognitive domains in females but not males. Conversely, TC and LDL levels were not associated with cognitive status in people with PD.ConclusionHigher serum HDL associates with poorer cognitive function in females with PD and presents a sex-specific biomarker for cognitive impairment in PD.

Levels of functional disability in elderly people in Tanzania with dementia, stroke and Parkinson’s disease

2015 ◽  
Vol 27 (4) ◽  
pp. 206-212 ◽  
Author(s):  
Aloyce Kisoli ◽  
William K. Gray ◽  
Catherine L. Dotchin ◽  
Golda Orega ◽  
Felicity Dewhurst ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Low Income ◽  
Functional Disability ◽  
Population Level ◽  
Severe Disability ◽  
Low Income Countries ◽  
Community Based ◽  
Demographic Ageing ◽  
People With Dementia

BackgroundDisability is associated with increasing age and poverty, yet there are few reliable data regarding disability amongst the elderly in low-income countries. The aim of this study was to compare disability levels for three of the most common neurological, non-communicable diseases: dementia, stroke and Parkinson’s disease (PD).MethodsWe performed a community-based study of people aged 70 years and over in 12 randomly selected villages in the rural Hai district of Tanzania. Participants underwent disability assessment using the Barthel Index, and clinical assessment for dementia, stroke and PD.ResultsIn a representative cohort of 2232 people aged 70 years and over, there were 54 cases of stroke, 12 cases of PD and estimated (by extrapolation from a sub-sample of 1198 people) to be 112 cases of dementia. People with stroke were the most disabled, with 62.9% having moderate or severe disability. Levels of moderate or severe disability were 41.2% in people with dementia and 50.0% in people with PD. However, the higher prevalence of dementia meant that, at a population level, it was associated with similar levels of disability as stroke, with 18.5% of 249 people identified as having moderate or severe disability having dementia, compared to 13.7% for stroke and 2.4% for PD.ConclusionsLevels of disability from these conditions is high and is likely to increase with demographic ageing. Innovative, community-based strategies to reduce disability levels should be investigated.

scholarly journals Cognitive Status Correlates with CXCL10/IP-10 Levels in Parkinson’s Disease

2014 ◽  
Vol 2014 ◽  
pp. 1-7 ◽  
Author(s):  
Natália Pessoa Rocha ◽  
Paula Luciana Scalzo ◽  
Izabela Guimarães Barbosa ◽  
Mariana Soares Souza ◽  
Isabela Boechat Morato ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Depressive Symptoms ◽  
Cognitive Performance ◽  
Plasma Levels ◽  
Plasma Concentrations ◽  
Cognitive Status ◽  
Enzyme Linked Immunosorbent Assay ◽  
Significant Difference ◽  
And Control

Cognitive impairment and depressive symptoms are of great interest in Parkinson’s disease (PD), since they are very common and lead to increased disability with poor quality of life. Inflammatory mechanisms have been implicated in PD and its nonmotor symptoms. In the current pilot study, we aimed to evaluate plasma levels of chemokines in PD patients and to analyze the putative association of chemokines with depressive symptoms and cognitive performance. We hypothesized that higher chemokines levels are associated with worse cognitive performance and increased depressive symptoms in PD. For this purpose, 40 PD patients and 25 age- and gender-matched controls were subjected to a clinical evaluation including cognitive and mood tests. Peripheral blood was drawn and plasma levels of CCL2/MCP-1, CCL11/eotaxin, CCL24/eotaxin-2, and CXCL10/IP-10 were measured by enzyme-linked immunosorbent assay. PD patients and control individuals presented comparable plasma concentrations of all the evaluated chemokines. In PD patients, CXCL10/IP-10 plasma levels correlated positively with Hoehn and Yahr staging scale. In addition, the higher CXCL10/IP-10 levels, the worse performance on cognitive tests. Although there was no significant difference between PD patients and control individuals regarding chemokines levels, our preliminary results showed that CXCL10/IP-10 may be associated with cognitive status in PD.

Informant-Reported Cognitive Decline is Associated with Objective Cognitive Performance in Parkinson’s Disease

2020 ◽  
pp. 1-11
Author(s):  
Marina Z. Nakhla ◽  
Kelsey A. Holiday ◽  
J. Vincent Filoteo ◽  
Zvinka Z. Zlatar ◽  
Vanessa L. Malcarne ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Executive Function ◽  
Cognitive Decline ◽  
Cognitive Performance ◽  
Cognitive Status ◽  
Delayed Recall ◽  
Visuospatial Function ◽  
Wide Range ◽  
Normal Cognition

Abstract Objective: The utility of informant-based measures of cognitive decline to accurately describe objective cognitive performance in Parkinson’s disease (PD) without dementia is uncertain. Due to the clinical relevance of this information, the purpose of this study was to examine the relationship between informant-based reports of patient cognitive decline via the Informant Questionnaire of Cognitive Decline in the Elderly (IQCODE) and objective cognition in non-demented PD controlling for cognitive status (i.e., mild cognitive impairment; PD-MCI and normal cognition; PD-NC). Method: One-hundred and thirty-nine non-demented PD participants (PD-MCI n = 38; PD-NC n = 101) were administered measures of language, executive function, attention, learning, delayed recall, visuospatial function, mood, and motor function. Each participant identified an informant to complete the IQCODE and a mood questionnaire. Results: Greater levels of informant-based responses of patient cognitive decline on the IQCODE were significantly associated with worse objective performance on measures of global cognition, attention, learning, delayed recall, and executive function in the overall sample, above and beyond covariates and cognitive status. However, the IQCODE was not significantly associated with language or visuospatial function. Conclusions: Results indicate that informant responses, as measured by the IQCODE, may provide adequate information on a wide range of cognitive abilities in non-demented PD, including those with MCI and normal cognition. Findings have important clinical implications for the utility of the IQCODE in the identification of PD patients in need of further evaluation, monitoring, and treatment.

scholarly journals Preliminary results of the cohort study of cognitive impairment associated with Parkinson’s disease

2021 ◽  
Vol 64 (3) ◽  
pp. 40-43
Author(s):  
Lila Rotaru ◽  
Keyword(s):  
Risk Factors ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Cohort Study ◽  
Cognitive Impairment ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Disease Duration ◽  
Cognitive Status ◽  
Lower Type

Background: Cognitive impairment (CI) is frequent in Parkinson’s disease (PD). CI patients have particular features. These are preliminary data of a cohort study of Moldovan patients with incident Parkinson’s disease. Material and methods: 65 out of 111 consecutive PD patients (mean age 64.87 ± 7.69 y.o.; disease duration 50.21 ± 38.61 mo.; 48 women (43.2%), 63 men (56.8%)) underwent Montreal Cognitive Assessment (MoCA) test. Cognitive status graded as: (1) normal and (2) impaired cognition. Results: There were similar: ages (65.79 ± 7.13 vs 62.17 ± 12.21 y.o.), onset ages (61.44 ± 7.61 vs 57.00 ± 12.95 years), disease duration (49.63 ± 36.78 vs 66.00 ± 26.48) months), levodopa (574.58 ± 129 vs 249.55) and agonists doses (5.19 ± 3.02 vs 1.05 ± 0.05) and Beck scores (8.13 ± 6.21 vs 7.4 ± 3.85), in groups. CI was present in 59 (90.8%) patients; more frequent in patients with cardiovascular risk factors (91.7%, p> 0.05), symmetrical Parkinsonism (93.2%, p> 0.05), and in first disease symptom bradykinesia patients (93.8%, p> 0.05). Upper / Lower Asymmetry Index were lower in CI patients, all lower type patients (p> 0.05) having CI. MoCA scores correlated with Unified Parkinson’s Disease Rating Scale in ON fase (UPDRSon), (r = -0.320, p <0.022), and red flags number (r = -0.590, p < 0.006). Conclusions: Cognitive impairment is more expectable in akinetic, symmetric and lower type Parkinsonism, also in patients with cardiovascular risk factors, with probable PD, and a more motor impairment.

Simple and low-cost mucuna pruriens preparation for Parkinson’s disease patients in low-income countries

2015 ◽  
Vol 357 ◽  
pp. e259 ◽  
Author(s):  
E. Cassani ◽  
M. Barichella ◽  
R. Cilia ◽  
J. Laguna ◽  
F. Sparvoli ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Low Income ◽  
Low Cost ◽  
Low Income Countries ◽  
Mucuna Pruriens

scholarly journals Review of Mucuna pruriens L. therapeutic potential for Parkinson’s disease

2020 ◽  
pp. 82-87
Author(s):  
A. S. Panova ◽  
D. S. Dergachev ◽  
M. A. Subotyalov ◽  
V. D. Dergachev
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Low Income ◽  
Therapeutic Potential ◽  
Symptomatic Relief ◽  
Complementary Therapy ◽  
Low Income Countries ◽  
Mucuna Pruriens ◽  
High Dose ◽  
Clinical Effects

Parkinson’s disease is a multifactorial disorder of the nervous system, the main features of which are progressive degeneration of dopaminergic neurons in the nigra pars compacta nigrostriatal tract and subsequent deficiency of the neurotransmitter dopamine in the areas of the brain, leading to the loss of motor function, the emergence of non-motor symptoms, rigidity, akinesia or bradykinesia, motor block, and decline in cognitive functions. Parkinson’s disease has high prevalence throughout the world, and has no curative treatment in modern medicine. The available drugs such as anticholinergics, levodopa and a DOPA-decarboxylase inhibitor provide symptomatic relief only. Although dopaminergic therapy is the standard treatment of motor disabilities associated with Parkinson’s disease, it does not managed all the aspects of the disease. For this reason, the increasing numbers of patients are looking for more holistic approach to the treatment of this disease. Mucuna pruriens L. – an annual self-pollinating legume plant, can be considered as a potential complementary therapy for patients with Parkinson’s disease, as it is an extremely rich source of levodopa. Numerous studies have shown that Mucuna pruriens extracts restore biochemical and behavioral abnormalities in animals with the experimental model of Parkinson’s disease. The plant also demonstrates some antioxidant activity. The clinical effects of high-dose Mucuna pruriens are similar to levodopa, but have a more favorable tolerance profile. If long-term use of Mucuna pruriens proves safe and effective in controlled clinical trials, it could become a sustainable complementary therapy for the treatment of Parkinson’s disease, especially in low-income countries.

scholarly journals Fluency in Parkinson’s disease: disease duration, cognitive status and age

2014 ◽  
Vol 72 (5) ◽  
pp. 349-355 ◽  
Author(s):  
Natalia Casagrande Brabo ◽  
Thais Soares C. Minett ◽  
Karin Zazo Ortiz
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Mini Mental State Examination ◽  
Disease Duration ◽  
Cross Sectional Study ◽  
Cognitive Status ◽  
Cross Sectional ◽  
Group I ◽  
Yahr Scale ◽  
State Examination

The objective of this study was to determine the frequency of occurrence and to characterize the typology of dysfluencies in individuals with Parkinson’s disease (PD), including the variables age, gender, schooling, disease duration, score on the Hoehn and Yahr scale and cognitive status (score on Mini-Mental State Examination). A cross-sectional study of a sample comprising 60 adults matched for gender, age and schooling was conducted. Group I comprised 30 adults with idiopathic PD, and Group II comprised 30 healthy adults. For assessment of fluency of speech, subjects were asked to utter a narrative based on a sequence of drawings and a transcription of 200 fluent syllables was performed to identify speech dysfluencies. PD patients exhibited a higher overall number of dysfluencies in speech with a large number of atypical dysfluencies. Additionally, results showed an influence of the variables cognitive status, disease duration and age on occurrence of dysfluencies.

Critical issues of the biopsychosocial treatment of Parkinson’s disease

2015 ◽  
Vol 156 (12) ◽  
pp. 472-478 ◽  
Author(s):  
Péter Kincses ◽  
Norbert Kovács ◽  
Kázmér Karádi ◽  
János Kállai
Keyword(s):  
Quality Of Life ◽  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Psychological Health ◽  
Interdisciplinary Approach ◽  
Cognitive Status ◽  
Psychological Burden ◽  
Her Family ◽  
Critical Issues

This paper is a summary report on the basic questions of the biopsychosocial approach to Parkinson’s disease. It deals with cognitive, affective and psychological health issues which significantly influence the outcome of the physical rehabilitation. In spite of the unchanged cognitive status, the psychological burden of the changes in the quality of life, the obstruction, the change in the affective tone, and the shrinking ability to fulfil social roles decrease the patient’s quality of life. An interdisciplinary approach is best suited for mitigating these effects. Not only the patient but also his/her family and environment is seriously affected by the disease and its consequences. Treatment and rehabilitation options for increasing or maintaining the quality of life of the affected patients are diverse, and significantly depend on the features of the health care system. The authors believe that the following review emphasizing health psychological principles may contribute to the work of professionals working in clinical and rehabilitational fields and through them may increase the quality of life of patients and their family. Orv. Hetil., 2015, 156(12), 472–478.

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