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From the Gertrude H. Sergievsky Center (Drs. Jacobs, Marder, Cote, Sano, Stern, and Mayeux) and the Departments of Neurology (Drs. Jacobs, Marder, Cote, Sano, Stern, and Mayeux) and Psychiatry (Drs. Stern and Mayeux), Columbia University College of Physicians and Surgeons; the Center for Alzheimer's Disease Research in the City of New York (Drs. Jacobs, Marder, Cote, Sano, Stern, and Mayeux); and the Division of Epidemiology (Dr. Mayeux), Columbia University School of Public Health, New York, NY.
Supported by federal grants AG07232, AG08702, AG10963, and RR00645 and by the Parkinson's Disease Foundation.
Received November 9, 1994. Accepted in final form February 3, 1995.
Address correspondence and reprint requests to Dr. Diane M. Jacobs, Gertrude H. Sergievsky Center, 630 West 168th Street, New York, NY 10032.
The goal of this study was to characterize the changes in cognition associated with the earliest, or preclinical, stages of dementia in Parkinson's disease (PD).We administered a comprehensive neuropsychological test battery to a group of initially nondemented PD patients participating in a longitudinal community-based epidemiologic study. We used Cox proportional hazards models to assess the relative risk of incident dementia associated with baseline scores on the neuropsychological tests. Baseline performance on two verbal fluency tasks (letter fluency and category fluency) was significantly and independently associated with incident dementia. Tests of memory, orientation, abstract reasoning, naming, and constructional skill were less sensitive predictors of subsequent dementia. The neuropsychological pattern characterizing the preclinical stages of dementia in PD differed from that described previously in preclinical Alzheimer's disease. Results suggest that poor performance on tests of verbal fluency may represent a distinct characteristic of the preclinical phase of dementia in PD.
NEUROLOGY 1995;45: 1691-1696
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