The spectrum of cognitive impairment in Lewy body diseases

Jennifer G Goldman*, Caroline Williams-Gray, Roger A. Barker, John E. Duda, James E. Galvin

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

65 Scopus citations

Abstract

Cognitive impairment represents an important and often defining component of the clinical syndromes of Lewy body disorders: Parkinson's disease and dementia with Lewy bodies. The spectrum of cognitive deficits in these Lewy body diseases encompasses a broad range of clinical features, severity of impairment, and timing of presentation. It is now recognized that cognitive dysfunction occurs not only in more advanced Parkinson's disease but also in early, untreated patients and even in those patients with pre-motor syndromes, such as rapid eye movement behavior disorder and hyposmia. In recent years, the concept of mild cognitive impairment as a transitional or pre-dementia state in Parkinson's disease has emerged. This has led to much research regarding the diagnosis, prognosis, and underlying neurobiology of mild cognitive impairment in Parkinson's disease, but has also raised questions regarding the usefulness of this concept and its application in clinical and research settings. In addition, the conundrum of whether Parkinson's disease dementia and dementia with Lewy bodies represent the same or different entities remains unresolved. Although these disorders overlap in many aspects of their presentations and pathophysiology, they differ in other elements, such as timing of cognitive, behavioral, and motor symptoms; medication responses; and neuropathological contributions. This article examines the spectrum and evolution of cognitive impairment in Lewy body disorders and debates these controversial issues in the field using point-counterpoint approaches.

Original languageEnglish (US)
Pages (from-to)608-621
Number of pages14
JournalMovement Disorders
Volume29
Issue number5
DOIs
StatePublished - Apr 15 2014

Keywords

  • Cognition
  • Dementia
  • Executive function
  • Mild cognitive impairment
  • Parkinson's disease

ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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