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Published online before print November 19, 2008, doi:10.1212/01.wnl.0000338632.00552.cb)
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Received May 29, 2008
Accepted September 26, 2008

Cognitive impairment in incident, untreated Parkinson disease: The Norwegian ParkWest Study

D. Aarsland MD*, K. Brønnick PhD, J. P. Larsen MD, O. B. Tysnes MD, G. Alves MD, For the Norwegian ParkWest Study Group

From The Norwegian Centre for Movement Disorders (D.A., K.B., J.P.L., G.A.), Department of Neurology (J.P.L., G.A.), and Department of Psychiatry (D.A.), Stavanger University Hospital, Stavanger; Department of Neurology (O.B.T.), Haukeland University Hospital, Bergen; and School of Medicine (D.A., J.P.L., O.B.T.), University of Bergen, Norway.


* To whom correspondence should be addressed. E-mail: daa{at}sus.no.

Background: Little is known regarding the cognitive impairment in subjects with early, drug-naïve Parkinson disease (PD). The aim of this study was to explore the proportion with mild cognitive impairment (MCI) and subtypes in an incidence cohort of untreated PD in Southern and Western Norway.

Methods: A total of 196 non-demented, drug-naive patients who were recruited after an extensive search of all new cases of PD in the area and 201 healthy control subjects completed a battery of neuropsychological tests of verbal memory, visuospatial, and attentional-executive functioning. Subjects were classified as MCI if the age- and education-corrected z-score was falling 1.5 standard deviations below the mean for at least one of the cognitive domains.

Results: The PD group was more impaired on all neuropsychological tests than controls, but the effect sizes were small. The largest effect size was found for verbal memory. A total of 18.9% of the patients with PD were classified as MCI, with a relative risk of 2.1 (1.2–3.6) in PD compared to the control group. Patients with PD with and without MCI did not differ significantly regarding demographic and motor features. Among PD-MCI patients, nearly two-thirds had a non-amnestic MCI subtype, and one third had an amnestic MCI subtype.

Conclusions: The findings demonstrate a twofold increase in the proportion with cognitive impairment in subjects with early, untreated Parkinson disease (PD) compared to controls. This has implications for diagnosis and management of PD.


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