Hostname: page-component-7c8c6479df-fqc5m Total loading time: 0 Render date: 2024-03-28T13:05:29.774Z Has data issue: false hasContentIssue false

Course of cognitive decline in Parkinson's disease: A meta-analysis

Published online by Cambridge University Press:  18 October 2007

DINO MUSLIMOVIĆ
Affiliation:
Department of Neurology, Academic Medical Centre, University of Amsterdam, The Netherlands
BEN SCHMAND
Affiliation:
Department of Neurology, Academic Medical Centre, University of Amsterdam, The Netherlands Department of Psychonomics, University of Amsterdam, The Netherlands
JOHANNES D. SPEELMAN
Affiliation:
Department of Neurology, Academic Medical Centre, University of Amsterdam, The Netherlands
ROB J. DE HAAN
Affiliation:
Department of Clinical Epidemiology and Biostatistics, Academic Medical Centre, University of Amsterdam, The Netherlands

Abstract

A meta-analysis was conducted on 25 longitudinal studies involving 901 initially non-demented Parkinson's disease (PD) patients to examine the magnitude of decline across multiple cognitive domains associated with disease progression. Pooled effect sizes reflecting the standardized difference between baseline and follow-up neuropsychological performance were calculated for 8 cognitive domains using a random-effects model. Relatively small effect sizes were found across all cognitive domains (d = .00 − .40). During a mean follow-up interval of 29 months, significant declines were detected in global cognitive ability (d = .40), visuoconstructive skills (d = .32), and memory (d = .29). Age showed a significant relation with decline in global cognitive ability and memory. Lower educational level was associated with greater decline in all cognitive domains. Studies with longer follow-up intervals yielded larger effect sizes for global cognitive ability. In non-demented PD patients, changes in cognitive functions over time appear to be modest. Educational level, age, and length of the follow-up interval are likely to affect the magnitude of decline in several domains. Methodological flaws, such as selection bias and uncontrolled practice effects, may have caused underestimation of the true extent of decline (JINS, 2007, 13, 920–932.)

Type
Research Article
Copyright
© 2007 The International Neuropsychological Society

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

REFERENCES1 References marked with an asterisk were included in the meta-analysis.

* Aarsland, D., Andersen, K., Larsen, J.P., Perry, R., Wentzel-Larsen, T., Lolk, A., & Kragh-Sørensen, P. (2004). The rate of cognitive decline in Parkinson disease. Archives of Neurology, 61, 19061911.Google Scholar
American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders (4th ed.). Washington, DC: American Psychiatric Association Press.
* Azuma, T., Cruz, R.F., Bayles, K.A., Tomoeda, C.K., & Montgomery, E.B. (2003). A longitudinal study of neuropsychological change in individuals with Parkinson's disease. International Journal of Geriatric Psychiatry, 18, 10431049.Google Scholar
Basso, M.R., Bornstein, R.A., & Lang, J.M. (1999). Practice effects on commonly used measures of executive function across twelve months. The Clinical Neuropsychologist, 3, 283292.Google Scholar
* Bayles, K.A., Tomoeda, C.K., Wood, J.A., Montgomery, E.B., Cruz, R.F., Azuma, T., & McGeagh, A. (1996). Change in cognitive function in idiopathic Parkinson disease. Archives of Neurology, 53, 11401146.Google Scholar
* Caparros-Lefebvre, D., Pecheux, N., Petit, V., Duhamel, A., & Petit, H. (1995). Which factors predict cognitive decline in Parkinson's disease? Journal of Neurology, Neurosurgery, and Psychiatry, 58, 5155.Google Scholar
Cohen, J. (1988). Statistical power analysis for the behavioral sciences (2nd ed.). Hillsdale, NJ: Erlbaum.
Cohn, L.D. & Becker, B.J. (2003). How meta-analysis increases statistical power. Psychological Methods, 3, 243253.Google Scholar
Della Sala, S., Di Lorenzo, G., Giordano, A., & Spinnler, H. (1986). Is there a specific visuo-spatial impairment in Parkinsonians? Journal of Neurology, Neurosurgery, and Psychiatry, 49, 12581265.Google Scholar
Dikmen, S.S., Heaton, R.K., Grant, I., & Temkin, N.R. (1999). Test-retest reliability and practice effects of Expanded Halstead-Reitan Neuropsychological Test Battery. Journal of the International Neuropsychological Society, 5, 346356.Google Scholar
Dubois, B. & Pillon, B. (1997). Cognitive deficits in Parkinson's disease. Journal of Neurology, 244, 28.Google Scholar
* Dujardin, K., Defebvre, L., Duhamel, A., Lecouffe, P., Rogelet, P., Steinling, M., & Destee, A. (2004). Cognitive and SPECT characteristics predict progression of Parkinson's disease in newly diagnosed patients. Journal of Neurology, 251, 13831392.Google Scholar
* Ebmeier, K.P., Calder, S.A., Crawford, J.R., Stewart, L., Besson, J.A.O., & Mutch, W.J. (1990). Clinical features predicting dementia in idiopathic Parkinson's disease: A follow-up study. Neurology, 40, 12221224.Google Scholar
* Firbank, M.J., Molloy, S., McKeith, I.G., Burn, D.J., & O'Brien, J.T. (2005). Longitudinal change in 99mTcHMPAO cerebral perfusion SPECT in Parkinson's disease over one year. Journal of Neurology, Neurosurgery, and Psychiatry, 76, 14481451.Google Scholar
Gib, W.R. & Lees, A.J. (1988). The relevance of the Lewy body to the pathogenesis of Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 51, 745752.Google Scholar
Glatt, S.L., Hubble, J.P., Lyons, K., Paolo, A., Tröster, A.I., Hassanein, R.E.S., & Koller, W.C. (1996). Risk factors for dementia in Parkinson's disease: Effect of education. Neuroepidemiology, 15, 2025.Google Scholar
* Growdon, J.H., Corkin, S., & Rosen, T.J. (1990). Distinctive aspects of cognitive dysfunction in Parkinson's disease. In M.B. Streifler, A.D. Korczyn, E. Melamed & M.B.H. Youdim (Eds.), Parkinson's disease: Anatomy, pathology, and therapy. Advances in Neurology, Vol. 53. New York: Raven Press.
* Hayashi, R., Hanyu, N., Kurashima, T., Tokutake, T., & Yanagisawa, N. (1996). Relationship between cognitive impairments, event-related potentials, and motor disability scores in patients with Parkinson's disease: 2-year follow-up study. Journal of the Neurological Sciences, 141, 4548.Google Scholar
Hedges, L.V. & Olkin, I. (1985). Statistical methods for meta-analysis. Orlando, FL: Academic Press.
Henry, J.D. & Crawford, J.R. (2004). Verbal fluency deficits in Parkinson's disease: A meta-analysis. Journal of the International Neuropsychological Society, 10, 608622.Google Scholar
Higgins, J.P.T., Thompson, S.G., Deeks, J.J., & Altman, D.G. (2003). Measuring inconsistency in meta-analyses. British Medical Journal, 327, 557560.Google Scholar
Hoehn, M.M. & Yahr, M.D. (1967). Parkinsonism: Onset, progression and mortality. Neurology, 17, 427442.Google Scholar
* Hovestadt, A. (1990). Parkinson's disease, pulmonary function and muscle strength. Rotterdam: Doctoral Dissertation.
* Hu, M.T.M., White, S.J., Chaudhuri, K.R., Morris, R.G., Bydder, G.M., & Brooks, D.J. (2001). Correlating rates of cerebral atrophy in Parkinson's disease with measures of cognitive decline. Journal of Neural Transmission, 108, 571580.Google Scholar
Jacqmin-Gadda, H., Fabrigoule, C., Commenges, D., & Dartigues, J.F. (1997). A 5-year longitudinal study of the Mini Mental State Examination in normal ageing. American Journal of Epidemiology, 6, 498506.Google Scholar
* Katsarou, Z., Bostantjopoulou, S., Alevriadou, A., Mentenopoulos, G., Avraam, X., & Kiosseoglou, G. (1998). A longitudinal study of visuospatial discrimination in parkinsonian patients. Perceptual and Motor Skills, 86, 171180.Google Scholar
Lange, K.W., Robbins, T.W., Marsden, C.D., James, M., Owen, A.M., & Paul, G.M. (1992). L-Dopa withdrawal in Parkinson's disease selectively impairs cognitive performance in tests sensitive to frontal lobe dysfunction. Psychopharmacology, 107, 394404.Google Scholar
Laupacis, A., Wells, G., Richardson, W.S., & Tugwell, P., for the Evidence-Based Medicine Working Group. (1994). Users' guides to the medical literature V: How to use an article about prognosis. Journal of American Medical Association, 3, 234237.Google Scholar
Levin, B.E., Llabre, M.M., Reisman, S., Weiner, W.J., Sanchez-Ramos, J., Singer, C., & Brown, M.C. (1991). Visuospatial impairment in Parkinson's disease. Neurology, 41, 365369.Google Scholar
Levin, B.E., Katzen, H.L., Klein, B., & Llabre, M.L. (2000). Cognitive decline affects subject attrition in longitudinal research. Journal of Clinical and Experimental Neuropsychology, 22, 580586.Google Scholar
Levin, B.E. & Katzen, H.L. (2005). Early cognitive changes and nondementing behavioral abnormalities in Parkinson's disease. Advances in Neurology, 96, 8494.Google Scholar
Lezak, M.D., Howieson, D.B., & Loring, D.W. (2004). Neuropsychological assessment (4th ed.). New York: Oxford University Press.
McCaffrey, R.J. & Westervelt, H.J. (1995). Issues associated with repeated neuropsychological assessments. Neuropsychology Review, 3, 203221.Google Scholar
* Morrison, C.E., Borod, J.C., Perrine, K., Beric, A., Brin, M.F., Rezai, A., Kelly, P., Sterio, D., Germano, I., Weisz, D., & Olanow, C.W. (2004). Neuropsychological functioning following bilateral subthalamic nucleus stimulation in Parkinson's disease. Archives of Clinical Neuropsychology, 19, 165181.Google Scholar
Muslimovic, D., Post, B., Speelman, J.D., & Schmand, B. (2005). Cognitive profile of patients with newly diagnosed Parkinson's disease. Neurology, 65, 12391245.Google Scholar
* Palazzini, E., Soliveri, P., Filippini, G., Fetoni, V., Zappacosta, B., Scigliano, G., Monza, D., Caraceni, T., & Girotti, F. (1995). Progression of motor and cognitive impairment in Parkinson's disease. Journal of Neurology, 242, 535540.Google Scholar
Park, H.L., O'Conell, E.O., & Thomson, R.G. (2003). A systematic review of cognitive decline in the general elderly population. International Journal of Geriatric Psychiatry, 18, 11211134.Google Scholar
* Perrine, K., Dogali, M., Fazzini, E., Sterio, D., Kolodny, E., Eidelberg, D., Devinsky, O., & Beric, A. (1998). Cognitive functioning after pallidotomy for refractory Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 65, 150154.Google Scholar
Portin, R. & Rinne, U.K. (1986). Predictive factors for cognitive deterioration and dementia in Parkinson's disease. In M.D. Yahr & K.J. Bergmann (Ed.), Advances in Neurology, Vol. 45. New York: Raven Press.
* Ramirez-Ruiz, B., Marti, M.J., Tolosa, E., Bartres-Faz, D., Summerfield, C., Salgado-Pineda, P., Gomez-Anson, B., & Junque, C. (2005). Longitudinal evaluation of cerebral morphological changes in Parkinson's disease with and without dementia. Journal of Neurology, 11, 13451352.Google Scholar
Raudenbush, S.W. (1994). Random effects model. In H. Cooper & L.V. Hedges (Ed.), The handbook of research synthesis. New York: Russell Sage Foundation.
Reid, W.G.J. (1992). The evolution of dementia in idiopathic Parkinson's disease: Neuropsychological and clinical evidence in support of subtypes. International Psychogeriatrics, 4, 147160.Google Scholar
Rosenberg, M.S., Adams, D.C., & Gurevitch, J. (2000). MetaWin: Statistical software for meta-analysis. Version 2. Sunderland, MA: Sinauer Associates.
Rosenthal, R. (1991). Meta-analytic procedures for social research (Rev. ed.). Newbury Park, CA: Sage.
* Schmand, B., de Bie, R.M.A., Koning-Haanstra, M., de Smet, J.S., Speelman, J.D., & van Zomeren, A.H., for the Netherlands Pallidotomy Study (NEPAS) group. (2000). Unilateral pallidotomy in PD. A controlled study of cognitive and behavioural effects. Neurology, 54, 10581064.Google Scholar
* Serrano-Dueñas, M. & Bleda, M.J. (2005). Delirium in Parkinson's disease patients. A five-year follow-up study. Parkinsonism and Related Disorders, 11, 387392.Google Scholar
* Smeding, H.M.M., Speelman, J.D., Koning-Haanstra, M., Schuurman, P.R., Nijssen, P., van Laar, T., & Schmand, B. (2006). Neuropsychological effects of bilateral STN stimulation in Parkinson disease. A controlled study. Neurology, 66, 18301836.Google Scholar
* Soliveri, P., Monza, D., Paridi, D., Carella, F., Genitrini, S., Testa, D., & Girotti, F. (2000). Neuropsychological follow-up in patients with Parkinson's disease, striatonigral degeneration-type multi-system atrophy, and progressive supranuclear palsy. Journal of Neurology, Neurosurgery, and Psychiatry, 69, 313318.Google Scholar
* Starkstein, S.E., Bolduc, P.L., Mayberg, H.S., Preziosi, T.J., & Robinson, R.G. (1990). Cognitive impairment and depression in Parkinson's disease: A follow-up study. Journal of Neurology, Neurosurgery, and Psychiatry, 53, 597602.Google Scholar
* Starkstein, S.E., Mayberg, H.S., Leiguarda, R., Preziosi, T.J., & Robinson, R.G. (1992). A prospective longitudinal study of depression, cognitive decline, and physical impairments in patients with Parkinson's disease. Journal of Neurology, Neurosurgery, and Psychiatry, 55, 377382.Google Scholar
* Stebbins, G.T., Gabrieli, J.D.E., Shannon, K.M., Penn, R.D., & Goetz C.G. (2000). Impaired frontostriatal cognitive functioning following posteroventral pallidotomy in advanced Parkinson's disease. Brain and Cognition, 42, 348363.Google Scholar
* Stern, Y., Tang, M.X., Jacobs, D.M., Sano, M., Marder, K., Bell, K., Dooneief, G., Schofield, P., & Cote, L. (1998). Prospective comparative study of the evolution of probable Alzheimer's disease and Parkinson's disease dementia. Journal of the International Neuropsychological Society, 4, 279284.Google Scholar
Stern, Y. (2002). What is cognitive reserve? Theory and research application of the reserve concept. Journal of the International Neuropsychological Society, 8, 448460.Google Scholar
Strauss, E., Sherman, E.M.S., & Spreen, O. (2006). A compendium of neuropsychological tests. Administration, norms and commentary (3rd ed.). New York: Oxford University Press.
* Tachibana, H., Tomino, Y., Kawabata, K., Sugita, M., & Fukuchi, M. (1995). Twelve-month follow-up study of regional cerebral blood flow in Parkinson's disease. Dementia, 6, 8993.Google Scholar
Zakzanis, K.K. & Freedman, M. (1999). A neuropsychological comparison of demented and non-demented patients with Parkinson's disease. Applied Neuropsychology, 3, 129146.Google Scholar