Predictors of Parkinson’s Disease Dementia Among Patients in a Tertiary Care Hospital in Bangladesh

Abstract

Background: Parkinson’s disease dementia (PDD) is a common consequence during the course of the disease. It deeply influences patients’ prognosis, quality of life, caregiver burden and economic strain. However, effective treatment for PDD is currently unclear. Clinical and demographic predictors for this comorbidity are not well studied. Objectives: To investigate putative risk factors for the development of dementia in patients with Parkinson’s disease (PD) attending a tertiary care and teaching hospital in Bangladesh. Methods: One hundred thirty-one consecutive PD cases were enrolled in this cross-sectional study; whose disease duration was more than a year. Comparison was done between demented and non-demented PD cases. Structural CNS diseases including secondary parkinsonism were excluded by clinically and MRI of brain for all cases. Dementia was evaluated based by DSM-IV and assessed using mini-mental state examination (MMSE) score and Parkinson’s disease dementia short screen (PDD-SS) score. Severity of disease was evaluated by Hoehn and Yahr stage (H-Y I to V). Depression was assessed using DSM-IV. Data were analysed on a logistic regression model using SPSS v 23. Results: The overall frequency of dementia was 38%. The mean (SD) age of the demented and non-demented PD cases was 73.32(8.86) and 63.98 (6.19) years respectively. On multivariate logistic regression model, age 370 years [OR=4.25, p=0.031], diabetes [OR=5.37, p=0.019], hypertension [OR=7.63, p=0.011], disease duration 35 years [OR=10.01, p<0.001], H-Y stage e” 3 [OR= 9.52, p<0.001] and depression [OR=8.79, p<0.001] were significantly associated with PDD. Conclusion: In this study of PD cases, overall risks of dementia were advancing age, diabetes, hypertension, longer disease duration, higher disease stage and presence of depressive illness.