Analyzing cognitive deficits and treatment options in Parkinson’s disease

Differentiate cognitive impairment from dementia, use the appropriate cognitive assessment, and treat PD dementia.

Kara J. Wyant, MD
Kara J. Wyant, MD
17th Dec 2023 • 1m read

The prevalence of Parkinson’s dementia is 30–40% in the PD population. Other than dementia, which usually presents later in the disease progression, there can also be mild cognitive impairment. In this lesson, we’ll explore the areas of cognition impacted by PD, the assessments used to test for cognitive dysfunction, and PD dementia treatment.

There are four areas, or domains, of cognition impacted in Parkinson’s disease:

  1. Executive function
  2. Complex attention
  3. Perceptual-motor function
  4. Learning and memory

If more than one domain is impacted and it affects activities of daily living, the patient is diagnosed with Parkinson’s dementia. However, if it has been less than a year since the onset of motor symptoms consider dementia with Lewy bodies.

The Montreal Cognitive Assessment, or MoCA, is the recommended global scale to assess cognition because it can assess executive function more sensitively. Neuropsychological testing remains the gold standard.

While early loss of cognitive function can be due to the loss of dopamine, later loss is often due to the loss of acetylcholine, and therefore cholinesterase inhibitors provide a modest benefit.

Dive into this course as we cover pathophysiology, evaluate common motor and non-motor symptoms, learn how to initiate the best therapy, and more!

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How confident are you in your ability to differentiate Parkinson’s disease from its look-alikes and correctly diagnose it? There is a gap in comprehensive training related to this complex disease and we are excited to bring you up to speed!