Risk of Cognitive Impairment in Patients With Parkinson’s Disease With Visual Hallucinations and Subjective Cognitive Complaints
Diego Santos‐García, Teresa de Deus Fonticoba, Carlos Cores Bartolomé, María J. Feal Painceiras, Jose Manuel Paz González, Cristina Martínez Miró, Silvia Jesús, Miquel Aguilar, Pau Pástor, Lluís Planellás, Marina Cosgaya, Juan García Caldentey, Núria Caballol, Inés Legarda, Jorge Hernández‐Vara, Iria Cabo, Lydia López Manzanares, Isabel González Aramburu, María A. Ávila Rivera, Víctor Gómez Mayordomo, Víctor Nogueira, Víctor Puente, Julio Dotor García‐Soto, Carmen Borrué, Berta Solano Vila, María Álvarez Saúco, Lydia Vela, Sonia Escalante, Esther Cubo, Francisco Carrillo Padilla, Juan Carlos Martínez‐Castrillo, Pilar Sánchez Alonso, Maria G. Alonso Losada, Núria López Ariztegui, Itziar Gastón, Jaime Kulisevsky, Marta Blázquez Estrada, Manuel Seijo, Javier Ruiz‐Martínez, Caridad Valero, Mónica Kurtis, Oriol de Fàbregues, Jessica González Ardura, Rubén Alonso Redondo, Carlos Ordás, Luis M. López Díaz L, Darrian McAfee, Pablo Martínez‐Martín, Pablo Mir, COPPADIS Study Group
Abstract
Background and Purpose Visual hallucinations (VH) and subjective cognitive complaints (SCC) are associated with cognitive impairment (CI) in Parkinson's disease.Our aims were to determine the association between VH and SCC and the risk of CI development in a cohort of patients with Parkinson's disease and normal cognition (PD-NC).Methods Patients with PD-NC (total score of >80 on the Parkinson's Disease Cognitive Rating Scale [PD-CRS]) recruited from the Spanish COPPADIS cohort from January 2016 to November 2017 were followed up after 2 years.Subjects with a score of 1 on domain 5 and item 13 of the Non-Motor Symptoms Scale at baseline (V0) were considered as "with SCC" and "with VH, " respectively.CI at the 2-year follow-up (plus or minus 1 month) (V2) was defined as a PD-CRS total score of <81.Results At V0 (n=376, 58.2% males, age 61.148.73 years [meanSD]), the frequencies of VH and SCC were 13.6% and 62.2%, respectively.VH were more frequent in patients with SCC than in those without: 18.8% (44/234) vs 4.9% (7/142), p<0.0001.At V2, 15.2% (57/376) of the patients had developed CI.VH presenting at V0 was associated with a higher risk of CI at V2 (odds ratio [OR]=2.68,95% confidence interval=1.05-6.83,p=0.039) after controlling for the effects of age, disease duration, education, medication, motor and nonmotor status, mood, and PD-CRS total score at V0.Although SCC were not associated with CI at V2, presenting both VH and SCC at V0 increased the probability of having CI at V2 (OR=3.71,95% confidence in-terval=1.36-10.17,p=0.011).Conclusions VH were associated with the development of SCC and CI at the 2-year follow-up in patients with PD-NC.