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Domain‐specific cognitive impairment in non‐demented Parkinson's disease psychosis
Author(s) -
Hinkle Jared T.,
Perepezko Kate,
Bakker Catherine C.,
Dawson Ted M.,
Johnson Vanessa,
Mari Zoltan,
Marvel Cherie L.,
Mills Kelly A.,
Pantelyat Alexander,
Pletnikova Olga,
Rosenthal Liana S.,
Shepard Melissa D.,
Stevens Daniel A.,
Troncoso Juan C.,
Wang Jiangxia,
Pontone Gregory M.
Publication year - 2018
Publication title -
international journal of geriatric psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.28
H-Index - 129
eISSN - 1099-1166
pISSN - 0885-6230
DOI - 10.1002/gps.4736
Subject(s) - psychosis , dementia , psychology , psychiatry , confounding , odds ratio , cognition , anosognosia , gee , clinical psychology , medicine , disease , generalized estimating equation , statistics , mathematics
In Parkinson's disease (PD), psychosis is associated with cognitive impairment that may be more profound in particular cognitive domains. Our goal was to determine whether psychosis in non‐demented PD participants is associated with domain‐specific cognitive impairment on the Mini‐Mental State Exam (MMSE). Methods The Morris K. Udall Parkinson's Disease Research Center of Excellence Longitudinal Study at Johns Hopkins is a prospective study that was initiated in 1998. Clinical assessments are conducted at two‐year intervals at the Johns Hopkins Hospital. We analyzed data from 137 enrolled participants with idiopathic PD. Psychosis diagnoses were established by psychiatrist interview per DSM‐IV criteria. An incident dementia diagnosis resulted in exclusion from analysis for that evaluation and any future evaluations in that participant. We used logistic regression with generalized estimated equations (GEE) to model the time‐varying relationship between MMSE subscale scores and psychosis, adjusting for potential confounding variables identified through univariable analysis. Results Thirty‐one unique psychosis cases were recorded among non‐demented participants. Fifty total evaluations with psychosis present were analyzed. In multivariable regressions, psychosis was associated with lower scores on the orientation (relative odds ratio, rOR: 0.73; 95% CI: 0.58–0.93; p = 0.011), language (rOR: 0.64; 95% CI: 0.48–0.86; p = 0.003), and intersecting pentagon (rOR: 0.43; 95% CI: 0.20–0.92 p = 0.030) subscales of the MMSE. Conclusions In PD, executive dysfunction, disorientation, and impaired language comprehension may be associated with psychosis. Our findings suggest that the corresponding MMSE subscales may be useful in identifying participants with a higher likelihood of developing psychosis. Copyright © 2017 John Wiley & Sons, Ltd.