Cognitive Impairment Profiles Differ Between Parkinson's, Alzheimer's

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As the neurodegenerative processes of Alzheimer disease and Parkinson disease are different, early cognitive impairment also present differently in these diseases.
As the neurodegenerative processes of Alzheimer disease and Parkinson disease are different, early cognitive impairment also present differently in these diseases.
The following article is part of conference coverage from the 2018 Alzheimer's Association International Conference in Chicago, Illinois. Neurology Advisor's staff will be reporting breaking news associated with research conducted by leading experts in neurology. Check back for the latest news from AAIC 2018.

CHICAGO — Mild cognitive impairment (MCI) associated with Parkinson disease (PD) demonstrates a greater executive dysfunction compared with MCI associated with Alzheimer disease (AD), according to data presented at the 2018 Alzheimer's Association International Conference, July 22-26, 2018 in Chicago, Illinois.

As the neurodegenerative processes of AD and PD are different, early cognitive impairment also present differently in these diseases. To assess the longitudinal profiles of cognitive domains as manifested in Alzheimer's (AD-MCI) vs Parkinson's (PD-MCI), study authors compared patients' cognitive profiles at baseline and change over 1 year.

The study included 59 patients with AD and 65 patients with PD who underwent full neuropsychological assessments at baseline and at year 1 follow-up. The Mann-Whitney U test was utilized to compare baseline cognitive scores; multiple comparisons were made after adjusting for sex, age, and education.

The data showed similar performance on global cognition tests (Mini-Mental State Exam and Montreal Cognitive Assessment) and on specific sub-domain measures of episodic memory and language. But in the areas of attention (P =.010), working memory (P <.000), and executive function (P =.045), patients with PD-MCI performed worse than patients with AD-MCI.

Patients with AD had a significantly higher chance of having a decline in attention from baseline vs those with PD (29% vs 16%; P =.039). However, the likelihood of declining in executive function from baseline was higher in the PD group vs AD group (12% vs 5%; P =.043). Study authors also noted that a proportion of patients in both groups showed improved attention (57% in PD and 40% in AD; P =.022).

"Despite similar global cognition scores, PD-MCI displayed greater executive dysfunction than AD-MCI, and different trajectories of domain-specific cognitive decline, suggesting that diagnosis and treatment of MCI in the two groups should be pathology-specific," stated lead author Audrey Low, BA. More research should be conducted regarding a possible reversible cognitive impairment in patients with PD-MCI as improvements in attention were seen, she added.

For more coverage of AAIC 2018, click here.

Reference

Low A, Yatawara C, Yong TT, et al. Mild cognitive impairment associated with Parkinson's disease (PD-MCI) and MCI associated with Alzheimer's disease (AD-MCI) have distinct cognitive profiles: a longitudinal study. Presented at: 2018 Alzheimer's Association International Conference. July 22-26, 2018; Chicago, IL. Poster P2-339.

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