Detecting cognitive impairment in patients with Parkinson's disease using a brief cognitive screening tool: Addenbrooke's Cognitive Examination (ACE)

Chade, Anabel; Roca, María; Torralva, Teresa; Gleichgerrcht, Ezequiel; Fabbro, Nicolás; Gómez Arévalo, Gonzalo; Gershanik, Oscar; Manes, Facundo

doi:10.1590/S1980-57642009DN20300006

Abstract

Detecting cognitive impairment in patients with Parkinson's disease is crucial for good clinical practice given the new therapeutic possibilities available. When full neuropsychological evaluations are not available, screening tools capable of detecting cognitive difficulties become crucial.

Objective:

The goal of this study was to investigate whether the Spanish version of the Addenbrooke's Cognitive Examination (ACE) is capable of detecting cognitive difficulties in patients with Parkinson's disease and discriminating their cognitive profile from patients with dementia.

Methods:

77 early dementia patients (53 with Alzheimer's Disease and 24 with Frontotemporal Dementia), 22 patients with Parkinson's disease, and 53 healthy controls were evaluated with the ACE.

Results:

Parkinson's disease patients significantly differed from both healthy controls and dementia patients on ACE total score.

Conclusions:

This study shows that the Spanish version of the ACE is capable of detecting patients with cognitive impairment in Parkinson's disease and is able to differentiate them from patients with dementia based on their general cognitive status.

Key words:
Parkinson's disease; Alzheimer's disease; frontotemporal dementia; screening tools; Addenbrooke's Cognitive Examination (ACE).

Resumo

A detecção de comprometimento cognitivo em pacientes com doença de Parkinson é crucial para uma boa prática clínica devido às novas possibilidades terapêuticas disponíveis. Quando uma avaliação neuropsicológica completa não está disponível, instrumentos de rastreio capazes de detectar dificuldades cognitivas tornam-se cruciais.

Objetivo:

Investigar se a versão espanhola do Addenbrooke´s Cognitive Examination (ACE) é capaz de detectar dificuldades cognitivas em pacientes com doença de Parkinson e discriminar seu perfil cognitivo de pacientes com demência.

Métodos:

77 pacientes com demência leve (53 com doença de Alzheimer e 24 com demência frontotemporal), 22 pacientes com doença de Parkinson e 53 controles saudáveis foram avaliados com a ACE.

Resultados:

Os pacientes com doença de Parkinson significativamente diferiram de controles saudáveis e pacientes com demência no escore total do ACE.

Conclusões:

Este estudo mostra que a versão espanhola do ACE é capaz de detectar pacientes com comprometimento cognitivo na doença de Parkinson e de diferenciá-los de pacientes com demência baseados no seu estado cognitivo geral.

Palavras-chave:
doença de Parkinson; doença de Alzheimer; demência frontotemporal; instrumentos de rastreio; Exame Cognitivo de Addenbrooke.

Texto completo disponível apenas em PDF.

Full text available only in PDF format.

References

¹
Parkinson J. An Essay on the Shaking Palsy. J Neuropsychiatry Clin Neurosci 2002;14:223-236.
²
Muslimovic D, Post B, Speelman JD, Schmand B. Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology 2005;65:1239-1244.
³
Foltynie T, Brayne CE, Robbins TW, Barker RA. The cognitive ability of an incident cohort of Parkinson's patients in the UK. The CamPaIGN study. Brain 2004;127:550-560.
⁴
Emre M. Dementia associated with Parkinson's disease. Lancet Neurol 2003;2:229-237.
⁵
Mathuranath PS, Nestor PJ, Berrios GE, Rakowicz W, Hodges JR. A brief cognitive test battery to differentiate Alzheimer's disease and frontotemporal dementia. Neurology 2000; 55:1613-1620.
⁶
Sarasola D, Calcagno ML, Sabe L, et al. El Addenbrooke's Cognitive Examination en español para el diagnóstico de demencia y para la diferenciación entre enfermedad de Alzheimer y demencia frontotemporal. Rev Neurol 2005;41:717-721.
⁷
Roca M, Torralva T, López P, Marengo J, Cetkovich M, Manes F. Diferenciación entre demencias en estadio inicial y depresión utilizando la versión española del Addenbrooke's Cognitive Examination. Rev Neurol 2008;46:340-343
⁸
Bak TH, Rogers TT, Crawford LM, Hearn VC, Mathuranath PS, Hodges JR. Cognitive bedside assessment in atypical parkinsonian syndromes. J Neurol Neurosurg Psychiatry 2005; 76:420-422.
⁹
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 1984;34:939-944.
¹⁰
Neary D, Snowden JS, Gustafson L, et al. Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 1998;51:1546-1554.
¹¹
Hughes CP, Berg L, Danzinger WL, Coben LA, Martin RL. A new clinical scale for staging of dementia. Br J Psychiatry 1982;140:566-572
¹²
Gibb WR, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry 1988;51:745-752.
¹³
Folstein MF, Folstein SE, McHugh PR. "Mini-Mental State": A practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975;12:189-198.
¹⁴
Williams-Gray CH, Foltynie T, Brayne CEG, Robbins TW, Barker RA. Evolution of cognitive dysfunction in an incident Parkinson's disease cohort. Brain 2007;130:1787-1798.

Publication Dates

Publication in this collection
Jul-Sep 2008

History

Received
17 July 2008
Accepted
21 Aug 2008

This is an open-access article distributed under the terms of the Creative Commons Attribution License

[1] ¹
Parkinson J. An Essay on the Shaking Palsy. J Neuropsychiatry Clin Neurosci 2002;14:223-236.

[2] ²
Muslimovic D, Post B, Speelman JD, Schmand B. Cognitive profile of patients with newly diagnosed Parkinson disease. Neurology 2005;65:1239-1244.

[3] ³
Foltynie T, Brayne CE, Robbins TW, Barker RA. The cognitive ability of an incident cohort of Parkinson's patients in the UK. The CamPaIGN study. Brain 2004;127:550-560.

[4] ⁴
Emre M. Dementia associated with Parkinson's disease. Lancet Neurol 2003;2:229-237.

[5] ⁵
Mathuranath PS, Nestor PJ, Berrios GE, Rakowicz W, Hodges JR. A brief cognitive test battery to differentiate Alzheimer's disease and frontotemporal dementia. Neurology 2000; 55:1613-1620.

[6] ⁶
Sarasola D, Calcagno ML, Sabe L, et al. El Addenbrooke's Cognitive Examination en español para el diagnóstico de demencia y para la diferenciación entre enfermedad de Alzheimer y demencia frontotemporal. Rev Neurol 2005;41:717-721.

[7] ⁷
Roca M, Torralva T, López P, Marengo J, Cetkovich M, Manes F. Diferenciación entre demencias en estadio inicial y depresión utilizando la versión española del Addenbrooke's Cognitive Examination. Rev Neurol 2008;46:340-343

[8] ⁸
Bak TH, Rogers TT, Crawford LM, Hearn VC, Mathuranath PS, Hodges JR. Cognitive bedside assessment in atypical parkinsonian syndromes. J Neurol Neurosurg Psychiatry 2005; 76:420-422.

[9] ⁹
McKhann G, Drachman D, Folstein M, Katzman R, Price D, Stadlan EM. Clinical diagnosis of Alzheimer's disease: report of the NINCDS-ADRDA Work Group under the auspices of department of Health and Human Services Task Force on Alzheimer's Disease. Neurology 1984;34:939-944.

[10] ¹⁰
Neary D, Snowden JS, Gustafson L, et al. Frontotemporal lobar degeneration: a consensus on clinical diagnostic criteria. Neurology 1998;51:1546-1554.

[11] ¹¹
Hughes CP, Berg L, Danzinger WL, Coben LA, Martin RL. A new clinical scale for staging of dementia. Br J Psychiatry 1982;140:566-572

[12] ¹²
Gibb WR, Lees AJ. The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson's disease. J Neurol Neurosurg Psychiatry 1988;51:745-752.

[13] ¹³
Folstein MF, Folstein SE, McHugh PR. "Mini-Mental State": A practical method for grading the cognitive state of patients for the clinician. J Psychiat Res 1975;12:189-198.

[14] ¹⁴
Williams-Gray CH, Foltynie T, Brayne CEG, Robbins TW, Barker RA. Evolution of cognitive dysfunction in an incident Parkinson's disease cohort. Brain 2007;130:1787-1798.

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