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December 10, 2002; 59 (11) Articles

Fluctuations in attention

PD dementia vs DLB with parkinsonism

C.G. Ballard, D. Aarsland, I. McKeith, J. O’Brien, A. Gray, F. Cormack, D. Burn, T. Cassidy, R. Starfeldt, J.-P. Larsen, R. Brown, M. Tovee
First published December 10, 2002, DOI: https://doi.org/10.1212/01.WNL.0000036908.39696.FD
C.G. Ballard
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D. Aarsland
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I. McKeith
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Citation
Fluctuations in attention
PD dementia vs DLB with parkinsonism
C.G. Ballard, D. Aarsland, I. McKeith, J. O’Brien, A. Gray, F. Cormack, D. Burn, T. Cassidy, R. Starfeldt, J.-P. Larsen, R. Brown, M. Tovee
Neurology Dec 2002, 59 (11) 1714-1720; DOI: 10.1212/01.WNL.0000036908.39696.FD

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Abstract

Background: Marked impairments in and fluctuation of attention are characteristic of dementia with Lewy bodies (DLB). The comparative impairment of these cognitive domains in PD and PD dementia (PD dementia) has not been studied, and is important to the conceptual understanding of parkinsonian dementias.

Method: Detailed evaluations of attention and fluctuating attention (Cognitive Drug Research computerized battery) were undertaken in 278 subjects (50 DLB, 48 PD dementia, 50 PD, 80 AD, 50 elderly controls) from the Newcastle dementia register and the Stavanger PD register (controls, PD, and PD dementia patients were recruited from both centers). DLB, AD, PD, and PD dementia were diagnosed using operationalized criteria.

Results: Impairments in reaction time, vigilance, and fluctuating attention were comparable in patients with DLB and PD dementia, but were less substantially impaired in patients with DLB without parkinsonism. Patients with PD had significantly greater impairment of cognitive reaction time than elderly controls, and comparable impairments of cognitive reaction time to patients with AD. Patients with PD, however, did not exhibit fluctuation of attention.

Conclusion: The profile of attentional impairments and fluctuating attention is similar in PD dementia and DLB with parkinsonism. The current findings do not support the current arbitrary distinctions between these patient groups. Importantly, patients with PD do not experience fluctuating attention.

  • Received February 26, 2002.
  • Accepted August 27, 2002.
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Letters: Rapid online correspondence

  • Fluctuations in attention: PD dementia vs DLB with parkinsonism
    • Olivier S Godefroy, MD, PhD, University Hospital, Amiens, Francegodefroy.olivier@chu-amiens.fr
    • Martine Roussel-Pieronne, Annie Routier, and Alain Rosa
    Submitted January 15, 2003
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  • All Neuropsychology/Behavior
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  • Dementia with Lewy bodies
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