Alexander Tröster, Ph.D.
At the Mild Cognitive Impairment (MCI) Symposium, Alexander Tröster, Professor of Neurology and Co-Director of the National Parkinson Foundation Center of Excellence at the University of North Carolina at Chapel Hill, gave a presentation on MCI in Parkinson’s disease (a Lewy body disorder).
There is a growing recognition that people diagnosed with Parkinson’s disease may have cognitive impairment in addition to their physical symptoms. A University of Amsterdam study found that 24 percent of patients newly diagnosed with Parkinson’s had cognitive impairment, especially problems with attention and the ability to organize and plan. In the same study, only four percent of healthy controls had cognitive impairment. More recent studies show 20 to 30 percent of people with Parkinson’s have MCI, and that their MCI tends to be Non-Amnestic and single domain.
Parkinson’s patients with MCI sometimes go on to develop full blown dementia (Parkinson’s disease with dementia), particularly those with the attention and planning problems mentioned above.
Dr. Tröster sees a lot of challenges when considering MCI in someone with Parkinson’s. It’s unclear which tests are best to detect MCI in Parkinson’s, he says, and Parkinson’s medicines can either contribute to or mask cognitive problems. It’s also unclear how likely it is that MCI in Parkinson’s will develop into Parkinson’s disease with dementia, or how an MCI diagnosis would change treatment.
Finally, he worries that people incorrectly think of MCI as a disease, rather than as a syndrome or group of symptoms. Many people, he says, view MCI as very mild Alzheimer’s disease. This can cause confusion, he thinks, and so he doesn’t like using the term “Mild Cognitive Impairment” to describe cognitive problems in people with Parkinson’s.
No matter what terms are used, further research is needed to improve our understanding of cognitive problems in Parkinson’s.
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