Sex differences in progression to mild cognitive impairment and dementia in Parkinson's disease

Brenna Cholerton, Catherine O. Johnson, Brian Fish, Joseph Quinn, Kathryn (Kathy) Chung, Amie Peterson, Liana S. Rosenthal, Ted M. Dawson, Marilyn S. Albert, Shu Ching Hu, Ignacio F. Mata, James B. Leverenz, Kathleen L. Poston, Thomas J. Montine, Cyrus P. Zabetian, Karen L. Edwards

Research output: Contribution to journalArticle

9 Citations (Scopus)

Abstract

Introduction: Identification of factors associated with progression of cognitive symptoms in Parkinson's disease (PD) is important for treatment planning, clinical care, and design of future clinical trials. The current study sought to identify whether prediction of cognitive progression is aided by examining baseline cognitive features, and whether this differs according to stage of cognitive disease. Methods: Participants with PD in the Pacific Udall Center Clinical Consortium who had longitudinal data available and were nondemented at baseline were included in the study (n = 418). Logistic and Cox regression models were utilized to examine the relationship between cognitive, demographic, and clinical variables with risk and time to progression from no cognitive impairment to mild cognitive impairment (PD-MCI) or dementia (PDD), and from PD-MCI to PDD. Results: Processing speed (OR = 1.05, p = 0.009) and working memory (OR = 1.01, p = 0.03) were associated with conversion to PDD among those with PD-MCI at baseline, over and above demographic variables. Conversely, the primary predictive factor in the transition from no cognitive impairment to PD-MCI or PDD was male sex (OR = 4.47, p = 0.004), and males progressed more rapidly than females (p = 0.01). Further, among females with shorter disease duration, progression was slower than for their male counterparts, and poor baseline performance on semantic verbal fluency was associated with shorter time to cognitive impairment in females but not in males. Conclusions: This study provides evidence for sex differences in the progression to cognitive impairment in PD, while specific cognitive features become more important indicators of progression with impending conversion to PDD.

Original languageEnglish (US)
JournalParkinsonism and Related Disorders
DOIs
StateAccepted/In press - Jan 1 2018

Fingerprint

Sex Characteristics
Parkinson Disease
Dementia
Demography
Neurobehavioral Manifestations
Cognitive Dysfunction
Short-Term Memory
Proportional Hazards Models
Semantics
Disease Progression
Logistic Models
Clinical Trials

Keywords

  • Cognition
  • Dementia
  • Mild cognitive impairment
  • Parkinson's disease
  • Sex differences

ASJC Scopus subject areas

  • Neurology
  • Geriatrics and Gerontology
  • Clinical Neurology

Cite this

Sex differences in progression to mild cognitive impairment and dementia in Parkinson's disease. / Cholerton, Brenna; Johnson, Catherine O.; Fish, Brian; Quinn, Joseph; Chung, Kathryn (Kathy); Peterson, Amie; Rosenthal, Liana S.; Dawson, Ted M.; Albert, Marilyn S.; Hu, Shu Ching; Mata, Ignacio F.; Leverenz, James B.; Poston, Kathleen L.; Montine, Thomas J.; Zabetian, Cyrus P.; Edwards, Karen L.

In: Parkinsonism and Related Disorders, 01.01.2018.

Research output: Contribution to journalArticle

Cholerton, B, Johnson, CO, Fish, B, Quinn, J, Chung, KK, Peterson, A, Rosenthal, LS, Dawson, TM, Albert, MS, Hu, SC, Mata, IF, Leverenz, JB, Poston, KL, Montine, TJ, Zabetian, CP & Edwards, KL 2018, 'Sex differences in progression to mild cognitive impairment and dementia in Parkinson's disease', Parkinsonism and Related Disorders. https://doi.org/10.1016/j.parkreldis.2018.02.007
Cholerton, Brenna ; Johnson, Catherine O. ; Fish, Brian ; Quinn, Joseph ; Chung, Kathryn (Kathy) ; Peterson, Amie ; Rosenthal, Liana S. ; Dawson, Ted M. ; Albert, Marilyn S. ; Hu, Shu Ching ; Mata, Ignacio F. ; Leverenz, James B. ; Poston, Kathleen L. ; Montine, Thomas J. ; Zabetian, Cyrus P. ; Edwards, Karen L. / Sex differences in progression to mild cognitive impairment and dementia in Parkinson's disease. In: Parkinsonism and Related Disorders. 2018.
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AU - Fish, Brian

AU - Quinn, Joseph

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AU - Peterson, Amie

AU - Rosenthal, Liana S.

AU - Dawson, Ted M.

AU - Albert, Marilyn S.

AU - Hu, Shu Ching

AU - Mata, Ignacio F.

AU - Leverenz, James B.

AU - Poston, Kathleen L.

AU - Montine, Thomas J.

AU - Zabetian, Cyrus P.

AU - Edwards, Karen L.

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N2 - Introduction: Identification of factors associated with progression of cognitive symptoms in Parkinson's disease (PD) is important for treatment planning, clinical care, and design of future clinical trials. The current study sought to identify whether prediction of cognitive progression is aided by examining baseline cognitive features, and whether this differs according to stage of cognitive disease. Methods: Participants with PD in the Pacific Udall Center Clinical Consortium who had longitudinal data available and were nondemented at baseline were included in the study (n = 418). Logistic and Cox regression models were utilized to examine the relationship between cognitive, demographic, and clinical variables with risk and time to progression from no cognitive impairment to mild cognitive impairment (PD-MCI) or dementia (PDD), and from PD-MCI to PDD. Results: Processing speed (OR = 1.05, p = 0.009) and working memory (OR = 1.01, p = 0.03) were associated with conversion to PDD among those with PD-MCI at baseline, over and above demographic variables. Conversely, the primary predictive factor in the transition from no cognitive impairment to PD-MCI or PDD was male sex (OR = 4.47, p = 0.004), and males progressed more rapidly than females (p = 0.01). Further, among females with shorter disease duration, progression was slower than for their male counterparts, and poor baseline performance on semantic verbal fluency was associated with shorter time to cognitive impairment in females but not in males. Conclusions: This study provides evidence for sex differences in the progression to cognitive impairment in PD, while specific cognitive features become more important indicators of progression with impending conversion to PDD.

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