Abstract Details

Title The Relationship Between Psychosis and Cognitive Function in Parkinson Disease

Topic Movement Disorders

Presentation(s) P4 - Poster Session 4 (11:45 AM-12:45 PM)

Poster/Presentation
Number 3-015

Objective

To investigate the relationship between psychotic ideation and cognitive function in Parkinson disease (PD).

Background

PD Patients are at risk for both cognitive decline and psychosis due to disease progression, medications, and other comorbidities. Dementia occurs in 30-40% and psychosis in 20-30% of PD patients.

Design/Methods A retrospective analysis of patients from the University of Maryland HOME Study was performed. Study assessments included Unified Parkinson Disease Rating Scale (UPDRS) item #2 score (Thought Disorder), UPDRS Motor score, Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA; converted to MMSE by established algorithm). Psychosis was defined as UPDRS #2 score ≥2. MMSE was compared pre- and post-psychosis with paired t-tests and ANCOVA adjusted for UPDRS motor.

Results 125 PD patients met inclusion criteria (age 65.4(9.1), 73% male, mean pre- and post-MMSE 28.6(1.8); 26.6(3.8), mean pre- and post-UPDRS 23.9(11.5); 31.0(14.6). The average time between pre- and post-psychosis was 4.5(3.7) years. MMSE significantly decreased following psychosis development (Δ 1.96, 95% CI, 1.29-2.63; p<0.0001). UPDRS Motor significantly worsened (Δ -7.13, 95% CI, -9.41 - -4.9; p<0.0001). Adjusting for UPDRS Motor, the MMSE change was no longer significant (p= 0.26).

Conclusions This study of the relationship between PD-related psychosis and cognition shows that the onset of psychosis is associated with cognitive decline, however, this relationship was no longer significant when adjusting for UPDRS Motor score. Further analyses are in progress including the effects of treatment of psychosis on cognition, the effects of psychosis on selected cognitive domains, and patient subgroups with/without improvement of psychosis overtime.

Authors/Disclosures
Nicole Bonsavage, MD (GBMC) PRESENTER	Dr. Bonsavage has nothing to disclose.
Sunita Shakya (UMB)	Sunita Shakya has nothing to disclose.
Ann Gruber-Baldini	No disclosure on file
Joseph M. Savitt, MD, PhD (University of Maryland)	The institution of Dr. Savitt has received research support from Bial. The institution of Dr. Savitt has received research support from UCB.
Stephen G. Reich, MD, FAAN (Univ of MD Hospital/Dept of Neuro)	Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Best Doctors. Dr. Reich has received personal compensation in the range of $500-$4,999 for serving as a Consultant for UpToDate. Dr. Reich has received personal compensation in the range of $10,000-$49,999 for serving as an Expert Witness for Various law firms. Dr. Reich has received publishing royalties from a publication relating to health care. Dr. Reich has received publishing royalties from a publication relating to health care.
F. Rainer Von Coelln, MD (University of Maryland School of Medicine)	The institution of Dr. Von Coelln has received research support from University of Maryland and Maryland State Goverment. Dr. Von Coelln has received intellectual property interests from a discovery or technology relating to health care.
Lisa M. Shulman, MD, FAAN (University of Maryland School of Medicine)	The institution of Dr. Shulman has received research support from NIH. Dr. Shulman has received publishing royalties from a publication relating to health care. Dr. Shulman has received publishing royalties from a publication relating to health care.

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