Movement Disorders with Dementia in Older Adults

Abstract

In old age, the most common dementias associated with movement disorders are Parkinson's disease (PD), Parkinson's disease dementia (PDD), dementia with Lewy bodies (DLB), corticobasal degeneration (CBD), and progressive supranuclear palsy (PSP). These conditions can be broadly grouped according to their characteristic neuropathologic features as synucleinopathies (DLB and PDD) or tauopathies (CBD and PSP). Clinical neuropsychological test findings by themselves are not diagnostic, and differentiation between synucleinopathies and tauopathies might be easier than distinguishing among synucleinopathies or among tauopathies. Indeed, the neuropsychological features of PDD and DLB are often indistinguishable even if subtle differences occasionally emerge and for this reason are considered together within this chapter. Despite neuropsychological overlap among dementias associated with different movement disorders, neuropsychological evaluation that carefully weighs test results, neuroimaging and neurological findings, interview information about disease course, emergence of various motor and non-motor symptoms (and their response to various treatments), and comorbidities can be helpful in supporting or ruling out a specific diagnosis. When patients with dementia and a movement disorder are referred for neuropsychological evaluation, the referral issue is often one of facilitating differential diagnosis and determining if additional factors (e.g., depression, medications, or medical conditions) are producing cognitive compromise. (PsycInfo Database Record (c) 2022 APA, all rights reserved)