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Cognitive decline in Parkinson’s disease: a subgroup of extreme decliners revealed by a data-driven analysis of longitudinal progression
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University Hospital.ORCID iD: 0009-0001-1035-5716
Umeå University, Faculty of Social Sciences, Umeå School of Business and Economics (USBE), Statistics. Umeå University, Faculty of Social Sciences, Centre for Demographic and Ageing Research (CEDAR).ORCID iD: 0000-0002-1812-3581
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI).ORCID iD: 0000-0001-6169-5836
Umeå University, Faculty of Medicine, Department of Integrative Medical Biology (IMB). Umeå University, Faculty of Medicine, Umeå Centre for Functional Brain Imaging (UFBI). Umeå University, Faculty of Medicine, Department of Radiation Sciences, Diagnostic Radiology. Center for the Economics of Aging, Max Planck Institute for Social Law and Social Policy, Germany.ORCID iD: 0000-0002-5389-1578
2021 (English)In: Frontiers in Psychology, E-ISSN 1664-1078, Vol. 12, article id 729755Article in journal (Refereed) Published
Abstract [en]

Cognitive impairment is an important symptom of Parkinson’s disease (PD) and predicting future cognitive decline is crucial for clinical practice. Here, we aim to identify latent sub-groups of longitudinal trajectories of cognitive change in PD patients, and explore predictors of differences in cognitive change. Longitudinal cognitive performance data from 349 newly diagnosed PD patients and 145 healthy controls from the Parkinson Progression Marker Initiative were modeled using a multivariate latent class linear mixed model. Resultant latent classes were compared on a number of baseline demographics, and clinical variables, as well as cerebrospinal fluid (CSF) biomarkers and striatal dopamine transporter (DAT) density markers of neuropathology. Trajectories of cognitive change in PD were best described by two latent classes. A large subgroup (90%), which showed a subtle impairment in cognitive performance compared to controls but remained stable over the course of the study, and a small subgroup (10%) which rapidly declined in all cognitive performance measures. Rapid decliners did not differ significantly from the larger group in terms of disease duration, severity or motor symptoms at baseline. However, rapid decliners had lower CSF amyloidß42 levels, a higher prevalence of sleep disorder and pronounced loss of caudate DAT density at baseline. These data suggest the existence of a distinct minority sub-type of PD in which rapid cognitive change in PD can occur uncoupled from motor symptoms or disease severity, likely reflecting early pathological change that extends from motor areas of the striatum into associative compartments and cortex.

Place, publisher, year, edition, pages
Frontiers Media S.A., 2021. Vol. 12, article id 729755
Keywords [en]
cognitive decline, Cluster analysis, Longitudinal, Parkinson's disease, subtypes
National Category
Neurosciences
Identifiers
URN: urn:nbn:se:umu:diva-186768DOI: 10.3389/fpsyg.2021.729755ISI: 000698637400001PubMedID: 34566817Scopus ID: 2-s2.0-85115623705OAI: oai:DiVA.org:umu-186768DiVA, id: diva2:1586483
Funder
EU, Horizon 2020, 716065Available from: 2021-08-20 Created: 2021-08-20 Last updated: 2025-07-08Bibliographically approved

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fulltext(780 kB)246 downloads
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Andersson, SaraJosefsson, MariaStiernman, Lars J.Rieckmann, Anna

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Department of Integrative Medical Biology (IMB)Umeå Centre for Functional Brain Imaging (UFBI)StatisticsCentre for Demographic and Ageing Research (CEDAR)Diagnostic Radiology
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