Domain-specific cognitive impairment in non-demented Parkinson's disease psychosis

Jared T. Hinkle, Kate Perepezko, Catherine C. Bakker, Ted M. Dawson, Vanessa Johnson, Zoltan Mari, Cherie L. Marvel, Kelly A. Mills, Alexander Pantelyat, Olga Pletnikova, Liana S. Rosenthal, Melissa D. Shepard, Daniel A. Stevens, Juan C. Troncoso, Jiangxia Wang, Gregory M. Pontone

Research output: Contribution to journalArticle

Abstract

Introduction: 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.

Original languageEnglish (US)
Pages (from-to)e131-e139
JournalInternational journal of geriatric psychiatry
Volume33
Issue number1
DOIs
StatePublished - Jan 2018

Keywords

  • MMSE
  • Parkinson's disease
  • cognitive domains
  • cognitive impairment
  • hallucinations
  • psychosis

ASJC Scopus subject areas

  • Geriatrics and Gerontology
  • Psychiatry and Mental health

Fingerprint Dive into the research topics of 'Domain-specific cognitive impairment in non-demented Parkinson's disease psychosis'. Together they form a unique fingerprint.

  • Cite this