| 1. |
- Elgh, Eva, et al.
(författare)
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Cognitive function in early Parkinson's disease : a population-based study
- 2009
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Ingår i: European Journal of Neurology. - : John Wiley & Sons. - 1351-5101 .- 1468-1331. ; 16:12, s. 1278-1284
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND PURPOSE: The study aims to describe the frequency, pattern and determinants of cognitive function in patients with newly diagnosed Parkinson's disease (PD); to compare patients with impaired cognition to patients with intact cognition; and to compare to matched healthy controls.METHODS: Patients were identified in a longitudinal population based study of idiopathic non-drug induced parkinsonism. Eighty-eight newly diagnosed patients with PD and no dementia were included during a four year period. The patients and 30 age- and sex-matched healthy control subjects underwent a comprehensive neuropsychological assessment.RESULTS: Patients performed significantly worse than healthy controls in a majority of neuropsychological tests. Test results in attention, psychomotor function, episodic memory (free recall), executive function and category fluency were significantly lower in the patient group. Comparison with normative data revealed that 30% of the patients had deficits in > or =1 cognitive domain (episodic memory, executive function and verbal function). Seventy per cent of the patients had normal performance. Unified Parkinson's Disease Rating Scale (UPDRS) III sub scores; speech, facial expression, rigidity and bradykinesia were significantly higher, and disease duration shorter amongst the cognitively impaired than amongst the cognitively intact patients. Tremor showed no difference. Education level was an independent predictor of dysfunction in patients with > or =2 cognitive domains affected.CONCLUSION: Cognitive dysfunction is common in untreated patients in early PD, affecting attention, psychomotor function, episodic memory, executive function and category fluency. Education level was an independent predictor of severe cognitive dysfunction.
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| 2. |
- Eriksson Domellöf, Magdalena, et al.
(författare)
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Olfactory dysfunction and dementia in newly diagnosed patients with Parkinson's disease
- 2017
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Ingår i: Parkinsonism & Related Disorders. - : Elsevier BV. - 1353-8020 .- 1873-5126. ; 38, s. 41-47
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Tidskriftsartikel (refereegranskat)abstract
- INTRODUCTION: Studies report that up to 90% of patients with idiopathic Parkinson's disease (PD) have olfactory dysfunction (hyposmia). Hyposmia has also been connected to cognitive impairment and dementia in PD, but no studies of newly diagnosed patients followed longer than three years exists. The present study investigates the prevalence of olfactory dysfunction at PD diagnosis, how it evolves over time and whether hyposmia increases the risk of dementia in Parkinson's disease.METHODS: Olfactory function was assessed with Brief Smell Identification Test (B-SIT) in 125 newly diagnosed patients with PD. They were followed for a maximum of 10 years (median six years) with extensive investigations at baseline, 12, 36, 60 and 96 months. Patients with B-SIT<9 were considered hyposmic.RESULTS: Hyposmia was found in 73% of the patients at diagnosis. During the follow up period of ten years 42 (46%) patients with hyposmia at baseline developed dementia compared to seven (21%) of the normosmic patients. Cox proportional hazards model showed that hyposmia at baseline (controlled for age, gender, UPDRS III and Mild Cognitive Impairment) increased the risk of developing dementia (hazard ratio (95%CI): 3.29 (1.44-7.52), p = 0.005). Only one of 22 patients with normal cognition and normal olfaction at baseline developed dementia.CONCLUSIONS: Olfactory dysfunction was common at the time of PD diagnosis and increased the risk of dementia up to ten years after PD diagnosis regardless of baseline cognitive function. Normal olfaction together with normal cognition at baseline predicted a benign cognitive course up to ten years after diagnosis.
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| 3. |
- Håglin, Lena, 1948-, et al.
(författare)
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Handgrip Strength and Anthropometry in Parkinson's Disease at Diagnosis
- 2022
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Ingår i: Parkinson's Disease. - : Hindawi Publishing Corporation. - 2090-8083 .- 2042-0080. ; 2022
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Tidskriftsartikel (refereegranskat)abstract
- Objectives. To investigate how age, malnutrition, and the level of plasma cortisol and phosphate in patients with Parkinson's disease (PD) at time of diagnosis are associated with body composition and handgrip strength in males and females compared to controls. Materials & Methods. This cross-sectional study includes baseline data from a cohort of newly diagnosed patients with Parkinson's disease (N = 75; M/F = 41/34) in the New Parkinsonism in Umeå study (NYPUM). Body Impedance (BIS), handgrip strength (HGS) assessments, and evaluation of risk for malnutrition (Mini Nutritional Assessment (MNA) score) and cognitive performance (Mini-Mental State Examination (MMSE)) were performed at time of PD diagnosis. Results. Low fat-free mass index (FFMI), MNA score, and a high Unified Parkinson's Disease Rating Scale (UPDRS-total and UPDRS-III) were associated with high daytime levels of P-cortisol in total PD population but not in controls. Partial correlations reveal that high fat mass percent (FM (%)) and low FFMI were associated with older age in males with PD but not females with PD. Risk of malnutrition was associated with P-cortisol in males but not in females with PD (r =-0.511, P=0.001, and n = 41 and r =-0.055, P=0.759, and n = 34, respectively). Multiple linear regressions show that an interaction between P-cortisol and P-phosphate, older age, and high UPDRS-III score were associated with HGS in total patient population and males but not females. Conclusions. Age-and disease-associated risk factors that decrease muscle mass and HGS and increase FM (%) in patients with PD differ between males and females by an association with levels of cortisol and phosphate.
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| 4. |
- Håglin, Lena, 1948-, et al.
(författare)
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Low level of phosphate in male patients reporting swallowing disturbances in early Parkinson's disease
- 2020
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Ingår i: Clinical Nutrition Experimental. - : Elsevier. - 2352-9393. ; 29, s. 18-29
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Tidskriftsartikel (refereegranskat)abstract
- Background & aim: Swallowing disturbances are associated with older age as well as with other subclinical disturbances of multifactorial origin in patients with Parkinson's disease (PD). This study assesses nutritional markers and whole-body impedance data to better understand swallowing disturbances in Parkinson's disease.Design and patients included: This cross-sectional study includes baseline data from a cohort of newly diagnosed patients identified in the New Parkinsonism in Umeå study (NYPUM) (n = 75).Methods: Swallowing disturbance was registered as a score of one or more on the Unified Parkinson's Disease Rating Scale (UPDRS) section II question number 7 on swallowing. The analysis used nutritional markers in plasma and anthropometry from bioimpedance.Results: Bivariate analysis revealed that swallowing disturbances were associated with low plasma phosphate levels for males (r = −0.428; p = 0.005) and for all patients with PD (r = −0.241; p = 0.037). In males but not in females, a negative association was found between age and albumin and amount of intra-cellular water (ICW, l). Plasma albumin was associated with plasma phosphate (r = 0.315; p = 0.006; n = 75, r = 0.361; p = 0.036; n = 34, r = 0.310; p = 0.049; n = 41). Another risk pattern indicating swallowing disturbance in females was revealed by an association with visceral adiposity index (VAI), plasma triglycerides (TG), and triglyceride/high density lipoprotein (TG/HDL) ratio. The adjusted logistic regression revealed that low phosphate in males and low magnesium in females were risk factors for swallowing disturbance.Conclusion: The age-related decline in plasma phosphate in males with PD may be an important nutritional marker for swallowing disturbances. Body composition measurements and nutritional markers provide information for the study of swallowing dysfunction as part of sarcopenia.
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| 5. |
- Linder, Jan, 1957-, et al.
(författare)
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Degenerative changes were common in brain magnetic resonance imaging in patients with newly diagnosed Parkinson's disease in a population-based cohort
- 2009
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Ingår i: Journal of Neurology. - Berlin : Springer. - 0340-5354 .- 1432-1459. ; 256:10, s. 1671-1680
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Tidskriftsartikel (refereegranskat)abstract
- The aim of this study was to investigate newly diagnosed patients with Parkinson's disease (PD) with structural magnetic resonance imaging (MRI), to compare them with healthy controls, to relate the findings to clinical subtypes - tremor dominant (TD) or postural instability and gait difficulty (PIGD) - and to investigate the relationship between both the duration from onset of symptoms to diagnosis and the severity of symptoms and the MRI findings. Patients with a definite PD diagnosis were compared to patients with a probable PD diagnosis. We hypothesized that the PIGD subtype, the probable PD group, a greater symptom severity and a longer symptom duration would all be associated with more frequent pathological findings. Sixty-six PD patients were included and examined with MRI, 35 with the PIGD subtype and 23 with the TD subtype. Fifty-three had definite PD and 13 probable PD. Thirty healthy individuals, matched for age and sex, served as controls. Degenerative changes in the cerebellar cortex and the superior cerebellar peduncle were significantly more common in the probable PD group than in the controls, suggesting the possibility of an emerging atypical parkinsonian disorder. No significant MRI differences were found between definite PD and controls, between definite PD and probable PD, nor between PIGD and TD. No significant associations were found between duration to diagnosis and MRI results, nor between severity of symptoms and MRI results. Thus, although pathological MRI findings were common they can not be used to separate subgroups of PD in newly diagnosed patients.
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| 6. |
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| 7. |
- Ådén, Emma, et al.
(författare)
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Dietary intake and olfactory function in patients with newly diagnosed Parkinson's disease : a case-control study.
- 2011
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Ingår i: Nutritional neuroscience. - 1476-8305. ; 14:1, s. 25-31
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: To evaluate energy and nutrient intake in newly diagnosed Parkinson's disease (PD) patients and association between olfaction and nutrient density of the diet. DESIGN: Baseline data from a prospective cohort study. SUBJECTS: Eighty-seven patients and 28 age- and sex-matched controls participated in the study. METHODS: Dietary intake was assessed by using 3-day dietary records and 24-hour dietary recalls. The Brief Smell Identification Test (B-SIT) was used to test olfaction. RESULTS: Patients, compared with controls, had lower intake of polyunsaturated fatty acids (P = 0.024) and a higher intake of carbohydrates (P = 0.027) in energy percent (E%). Lower intake of protein (E%) (P = 0.045), and a low nutrient density of folate (P = 0.022), magnesium (P = 0.012), and phosphorus (P = 0.029) were associated with lower B-SIT score in both patients and controls. PD patients had a lower B-SIT score than controls (P < 0.001). CONCLUSION: The results indicate a higher relative contribution of energy from carbohydrates in PD patients. An association between low protein, folate, magnesium, and phosphorus density of the diet and olfaction was seen in the whole population.
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