J Clin Neurol.  2023 Jul;19(4):344-357. 10.3988/jcn.2022.0186.

Risk of Cognitive Impairment in Patients With Parkinson’s Disease With Visual Hallucinations and Subjective Cognitive Complaints

• Santos-García D
• Fonticoba TdD
• Bartolomé CC
• Painceiras MJF
• González JMP
• Miró CM
• Jesús S
• Aguilar M
• Pastor P
• Planellas L
• Cosgaya M
• Caldentey JG
• Caballol N
• Legarda I
• Vara JH
• Cabo I
• Manzanares LL
• Aramburu IG
• Rivera MA
• Mayordomo VG
• Nogueira V
• Puente V
• García-Soto JD
• Borrué C
• Vila BS
• Sauco M
• Vela L
• Escalante S
• Cubo E
• Padilla FC
• Castrillo JCM
• Alonso PS
• Losada MGA
• Ariztegui NL
• Gastón I
• Kulisevsky J
• Estrada MB
• Seijo M
• Martínez JR
• Valero C
• Kurtis M
• Fábregues Od
• Ardura JG
• Redondo RA
• Ordás C
• Díaz L LML
• McAfee D
• Martinez-Martin P
• Mir P
• COPPADIS Study Group

• KMID: 2543829
• DOI: http://doi.org/10.3988/jcn.2022.0186

Abstract

Background and Purpose
Visual hallucinations (VH) and subjective cognitive complaints (SCC) are associated with cognitive impairment (CI) in Parkinson’s disease. Our aims were to determine the association between VH and SCC and the risk of CI development in a cohort of patients with Parkinson’s disease and normal cognition (PD-NC).
Methods
Patients with PD-NC (total score of >80 on the Parkinson’s Disease Cognitive Rating Scale [PD-CRS]) recruited from the Spanish COPPADIS cohort from January 2016 to November 2017 were followed up after 2 years. Subjects with a score of ≥1 on domain 5 and item 13 of the Non-Motor Symptoms Scale at baseline (V0) were considered as “with SCC” and “with VH,” respectively. CI at the 2-year follow-up (plus or minus 1 month) (V2) was defined as a PD-CRS total score of <81.
Results
At V0 (n=376, 58.2% males, age 61.14±8.73 years [mean±SD]), the frequencies of VH and SCC were 13.6% and 62.2%, respectively. VH were more frequent in patients with SCC than in those without: 18.8% (44/234) vs 4.9% (7/142), p<0.0001. At V2, 15.2% (57/376) of the patients had developed CI. VH presenting at V0 was associated with a higher risk of CI at V2 (odds ratio [OR]=2.68, 95% confidence interval=1.05–6.83, p=0.039) after controlling for the effects of age, disease duration, education, medication, motor and nonmotor status, mood, and PD-CRS total score at V0. Although SCC were not associated with CI at V2, presenting both VH and SCC at V0 increased the probability of having CI at V2 (OR=3.71, 95% confidence interval=1.36–10.17, p=0.011).
Conclusions
VH were associated with the development of SCC and CI at the 2-year follow-up in patients with PD-NC.

Keyword

cognitive impairment; dementia; parkinson’s disease; subjective cognitive complaints; visual hallucinations