Cognitive, Functional Declines Steeper in Older Adults With Prediagnostic Parkinson Disease

Older adults with prediagnostic Parkinson disease experience cognitive and functional decline beyond that associated with normal aging, according to study results published in Neurology.

Researchers from the University of California, San Francisco, and the Minneapolis Veteran’s Affairs Health Care System in Minnesota investigated prediagnostic cognitive and functional trajectories in 15,390 community-dwelling older adults over as many as 20 years. Over follow-up, 297 of the participants developed incident Parkinson disease.

Over the prediagnostic period, men who developed Parkinson disease experienced faster decline in global cognition (0.04 standard deviation more annual change), executive function (0.05 standard deviation more annual change), and functional status (0.06 standard deviation more annual change) than other men in the study, researchers reported. 

Meanwhile, women who developed Parkinson disease exhibited faster decline in executive function (0.02 standard deviation more annual change) and functional status (0.07 standard deviation more annual change) in the prediagnostic period than women who did not develop the condition.

“Better understanding heterogeneity in prodromal Parkinson disease is essential to enable earlier diagnosis and identify impactful nonmotor symptoms in all subgroups,” the authors advised.

Reference:
Bock MA, Vittinghoff E, Bahorik AL, Leng Y, Fink H, Yaffe K. Cognitive and functional trajectories in older adults with prediagnostic Parkinson disease. Neurology. Published online December 29, 2022. doi:10.1212/WNL.0000000000206762