Motor and cognitive decline of healthy elderly and elderly with parkinson’s disease - a cross-sectional study
Gomes, Wildja de Lima; Silva, Neildja Maria da; Silva, Laize Gabriele Castro; Cacho, Ênio Walker Azevedo; Cacho, Roberta de Oliveira; Cruz, Maria do Socorro Luna; Lima, Núbia Maria Freire Vieira
Background: Parkinson’s disease (PD) was initially described as a movement disorder, however there is now recognition that its clinical features also include non-motor symptoms such as cognitive impairment and dementia, which are frequent even in the early stages of the disease and, especially in the advanced stages. Cognitive deficits in PD include impairments in executive functions, attention, memory, and visuospatial skills. Cognitive impairment may manifest as mild cognitive impairment (MCI) or dementia, in which MCI refers to the stage between normal cognitive functioning and dementia. Factors associated with cognitive dysfunction in PD include advanced age, low schooling, worse motor scores, stiffness, postural instability and increased daytime sleepiness. Objective: To track cognitive decline and to correlate measurement instruments in subjects with PD by comparing them to healthy subjects. Methods: Study conducted at the Faculty of Health Sciences of Trairi / UFRN. The sample consisted of 20 old people (10 healthy elderlies and 10 elderlies with PD). It was applied the socio-demographic record, Unified Parkinson’s Disease Rating Scale (UPDRS II and III), Hoehn & Yahr Scale, Mini Mental State Examination, Leganés Cognitive Test (LCT) and Montreal Cognitive Assessment (MoCA). Results: It was observed cognitive decline in both groups by MoCA (90% of the PD group and 80% of the healthy group), with no statistically significant difference (p=0.10). It was also verified association between UPDRS II and LCT (r= -0.69, p=0.03) and between UPDRS III and LCT (r=-0.66, p=0.04). Conclusion: We found a cognitive deficit in the elderly group with PD, with no significant difference when compared to the healthy elderly. There was an association between motor and cognitive function in subjects with PD. MoCA was more sensitive in the screening of cognitive deficit in subjects with PD.
1. Calleo J, Burrows C, Levin H, Marsh L, Lai E, York M. Cognitive Rehabilitation for Executive Dysfunction in Parkinson’s Disease: Application and Current Directions. Parkinson’s Disease. 2012;2012:1-6.
2. Reid W, Hely M, Morris J, Loy C, Halliday G. Dementia in Parkinson’s disease: a 20-year neuropsychological study (Sydney Multicentre Study). Journal of Neurology, Neurosurgery & Psychiatry. 2011;82(9):1033-1037.
3. Pagonabarraga J, Kulisevsky J. Cognitive impairment and dementia in Parkinson’s disease. Neurobiology of Disease. 2012;46(3):590-596.
4. Pfeiffer H, Løkkegaard A, Zoetmulder M, Friberg L, Werdelin L. Cognitive impairment in early-stage non-demented Parkinson’s disease patients. Acta Neurologica Scandinavica. 2013;129(5):307-318.
5. Aarsland D, Bronnick K, Larsen J, Tysnes O, Alves G. Cognitive impairment in incident, untreated Parkinson disease: The Norwegian ParkWest Study. Neurology. 2008;72(13):1121-1126.
6. Hoops S, Nazem S, Siderowf A, Duda J, Xie S, Stern M et al. Validity of the MoCA and MMSE in the detection of MCI and dementia in Parkinson disease. Neurology. 2009;73(21):1738-1745.
7. Almeida I, Bueno M, Andrello A, Batistetti C, Lemes L, Barboza N et al. Fisioterapia baseada no treinamento de dupla tarefa no equilíbrio de indivíduos com doença de Parkinson. Saúde (Santa Maria). 2015;41(2).
8. Lescano S. Investigação de queixa específica de deglutição para medicamentos em pacientes com diagnóstico de doença de Parkinson [Graduação]. Universidade Federal do Rio Grande do Sul; 2013.
9. Fahn S, Marsden C, Van Woert M. Myoclonus. New York: Raven Press; 1986.
10. Hoehn M, Yahr M. Parkinsonism: Onset, progression, and mortality. Neurology. 1998;50(2):318.
11. Schenkman M, Clark K, Xie T, Kuchibhatla M, Shinberg M, Ray L. Spinal Movement and Performance of a Standing Reach Task in Participants With and Without Parkinson Disease. Physical Therapy. 2001;81(8):1400-1411
12. Burns A, Brayne C, Folstein M. Key Papers in Geriatric Psychiatry: minimental state: a practical method for grading the cognitive state of patients for the clinician. M. Folstein, S. Folstein and P. McHugh,Journal of Psychiatric Research, 1975,12, 189-198.
13. Bertolucci P, Brucki S, Campacci S, Juliano Y. O Mini-Exame do Estado Mental em uma população geral: impacto da escolaridade. Arquivos de Neuro-Psiquiatria. 1994;52(1):01-07.
14. Zunzunegui M, Gutiérrez Cuadra P, Béland F, Del Ser T, Wolfson C. Development of simple cognitive function measures in a community dwelling population of elderly in Spain. International Journal of Geriatric Psychiatry. 2000;15(2):130-140.
15. Caldas V, Zunzunegui M, Freire A, Guerra R. Translation, cultural adaptation and psychometric evaluation of the Leganés cognitive test in a low educated elderly Brazilian population. Arquivos de Neuro-Psiquiatria. 2012;70(1):22-27
16. Nasreddine Z, Phillips N, Badirian V, Charbonneau S, Whitehead V, Collin I et al. The Montreal Cognitive Assessment, MoCA: A Brief Screening Tool For Mild Cognitive Impairment. Journal of the American Geriatrics Society. 2005;53(4):695-699.
17. Sobreira E, Pena-Pereira M, Eckeli A, Sobreira-Neto M, Chagas M, Foss M et al. Screening of cognitive impairment in patients with Parkinson’s disease: diagnostic validity of the Brazilian versions of the Montreal Cognitive Assessment and the Addenbrooke’s Cognitive ExaminationRevised. Arquivos de Neuro-Psiquiatria. 2015;73(11):929-933.
18. Zadikoff C, Fox S, Tang-Wai D, Thomsen T, de Bie R, Wadia P et al. A comparison of the mini mental state exam to the montreal cognitive assessment in identifying cognitive deficits in Parkinson’s disease. Movement Disorders. 2007;23(2):297-299.
19. Munro B, Plichta S, Kelvin E. Munro’s statistical methods for health care research. Philadelphia, PA: Wolters Kluwer, Lippincott Williams & Wilkins; 2013.
20. Ling C, Cuiyu Y, Xiaosu F, Weiguo L, Ping H, Ning Z, Shenghan K. Using the Montreal Cognitive Assessment Scale to screen for dementia in Chinese patients with Parkinson’s disease. Shanghai Arch Psychiatry. 2013 Oct; 25(5):296–305.
21. Baggio J, Curtarelli M, Rodrigues G, Tumas V. Validity of the Brazilian version of the freezing of gait questionnaire. Arquivos de NeuroPsiquiatria. 2012;70(8):599-603.
22. Macuglia G, Rieder C, Trentini L, Filho N, Moraes A, Almeida R. Comprometimento Executivo nas Fases Leve à Grave da Doença de Parkinson. Psico. 2015;46(2):198.
23. Chou K, Lenhart A, Koeppe R, Bohnen N. Abnormal MoCA and normal range MMSE scores in Parkinson disease without dementia: Cognitive and neurochemical correlates. Parkinsonism & Related Disorders. 2014;20(10):1076-1080
24. Lucza T, Karádi K, Kállai J, Weintraut R, Janszky J, Makkos A et al. Screening Mild and Major Neurocognitive Disorders in Parkinson’s Disease. Behavioural Neurology. 2015;2015:1-10
25. Kim J, Sunwoo M, Sohn Y, Lee P, Hong J. The MMSE and MoCA for Screening Cognitive Impairment in Less Educated Patients with Parkinson’s Disease. Journal of Movement Disorders. 2016;9(3):152-159.
26. Memória C, Yassuda M, Nakano E, Forlenza O. Brief screening for mild cognitive impairment: validation of the Brazilian version of the Montreal cognitive assessment. International Journal of Geriatric Psychiatry. 2012;28(1):34-40.