ABSTRACT
Patients with Parkinson's disease (PD) and matched control subjects were photographed posing a range of facial expressions. The same subjects were later asked to identify the posed expressions of the other subjects. They were also asked to rate the quality of expressions posed by the control subjects after being told what each expression was. Expressions posed by healthy control subjects were more readily identifiable than expressions posed by Parkinson's patients, but the two groups did not differ in their ability to recognize facial expressions or in the goodness ratings they gave, and their error patterns were closely similar. There was no significant difference between the groups on other tests of face processing or on ratings of emotionality except for greater reported anxiety in the Parkinson's patients. We conclude that although patients with PD have reduced facial expressiveness, there is no apparent diminution in their comprehension of facial expressions or their day-to-day experience of emotion.
Subject(s)
Dementia/diagnosis , Neuropsychological Tests , Parkinson Disease/diagnosis , Aged , Cohort Studies , Dementia/mortality , Dementia/psychology , Disability Evaluation , Female , Follow-Up Studies , Humans , Longitudinal Studies , Male , Middle Aged , Neurologic Examination , Parkinson Disease/mortality , Parkinson Disease/psychology , Prospective Studies , Psychiatric Status Rating Scales , Risk Factors , Survival AnalysisABSTRACT
Serial assessments of cognition, mood, and disability were carried out at nine month intervals over a 54 month period on a cohort of 87 patients with Parkinson's disease (PD) and a matched cohort of 50 control subjects. Dementia was diagnosed from data by rigorously applying DSM-III-R criteria. Initially, 6% (5/87) PD patients were demented, compared with none of the 50 control subjects. A further 10 PD patients met the dementia criteria during the follow up period; this was equivalent, with survival analysis, to a cumulative incidence of 19%. With the number of person years of observation as the denominator, the incidence was 47.6/1000 person years of observation. None of the control subjects fulfilled dementia criteria during the follow up period. The patients with PD who became demented during follow up were older at onset of Parkinson's disease than patients who did not become demented, had a longer duration of Parkinson's disease, and were older at inclusion to the study.
Subject(s)
Dementia/diagnosis , Parkinson Disease/diagnosis , Aged , Cohort Studies , Cross-Sectional Studies , Dementia/epidemiology , Disability Evaluation , England/epidemiology , Follow-Up Studies , Humans , Incidence , Longitudinal Studies , Middle Aged , Neurologic Examination , Neuropsychological Tests , Parkinson Disease/epidemiology , Survival Rate , Wechsler ScalesABSTRACT
The performance of 47 patients with Parkinson's disease on a battery of tests of cognition, motor function, disability and mood was compared with the performance of 47 healthy control subjects who were matched to the patients on the basis of age, sex and pre-morbid IQ. An increased prevalence of impairment over a range of cognitive functions was observed in the Parkinson's disease patients as compared with their matched controls. The differences between the Parkinson's disease patients and controls could not be accounted for by factors such as depressed mood, effects of medication or motor impairment. Our findings are discussed in relation to the methodology of previous studies in this area and to the need for a comprehensive clinico-pathological longitudinal study.
Subject(s)
Cognition Disorders/diagnosis , Dementia/diagnosis , Neuropsychological Tests , Parkinson Disease/diagnosis , Activities of Daily Living/psychology , Affective Symptoms/diagnosis , Affective Symptoms/psychology , Aged , Cognition Disorders/psychology , Cohort Studies , Dementia/psychology , Female , Humans , Intelligence , Male , Middle Aged , Neurologic Examination , Parkinson Disease/psychology , Wechsler ScalesABSTRACT
There is no guidance available for clinicians who have to decide on the fitness to drive of patients who have Parkinson's disease (PD). A computerised driving simulator was used to examine the effect of PD on driving ability. Ten drivers with idiopathic PD were tested as well as 10 age and sex-matched healthy drivers and four PD drivers who were no longer driving. Both the simulated driving reaction time and the accuracy of steering were significantly impaired in the PD group compared with the controls. Both of these measures correlated significantly with the severity of PD as measured on Webster's rating scale. Caution may be needed if the findings of simulated tests are to be extrapolated to real driving. However, our findings show that the severity of disability in PD as measured by Webster's rating scale may assist in assessing the fitness of a PD patient to drive.
