Emre et al listed criteria for the diagnosis of dementia associated with Parkinson's disease. The authors are from multiple institutions from around the world.



(1) core features

(2) associated clinical features - cognitive

(3) associated clinical features - behavioral

(4) features making the diagnosis uncertain

(5) features making the diagnosis doubtful or difficult


Core features:

(1) diagnosis of Parkinson's disease

(2) dementia of slow progression within the setting of Parkinson's disease with all of the following:

(2a) impairment in 2 or more cognitive domains

(2b) decline from premorbid level

(2c) impairment in activities of daily living

Cognitive Feature




difficulty with attention tasks; may fluctuate from day to day and during the day


executive functions

difficulty initiating, planning, forming concepts, rule finding, set shifting, mental speed


visuo-spatial functions

difficulty with tasks requiring visual and/or spatial orientation, perception or construction



poor recall for recent events, new material, improves with cueing, recognition better than free recall

does not improve with cueing or in recognition


preserved but may have difficulty with word finding or understanding complex sentences

prominent or fluent aphasia


Behavioral features:

(1) apathy

(2) change in mood and/or personality

(3) hallucinations (often visual)

(4) delusions (often of the paranoid type)

(5) excessive daytime sleepiness


Features making the diagnosis uncertain:

(1) presence of another disease that can explain the cognitive difficulties

(2) time interval between development of motor and cognitive symptoms unknown (with dementia in Parkinson's disease the motor problems should appear before the cognitive decline)


Features making the diagnosis doubtful or difficult

(1) vascular disease sufficient to cause vascular dementia

(2) acute confusion due to drug intoxication, systemic disease, etc

(3) major depression



Probable Dementia-PD

Possible Dementia-PD

core features



cognitive features

>= 2 typical

present; may be typical or atypical

behavioral features

>= 1 supports, absence does not exclude


features making uncertain


1 or more

features for doubtful or difficult diagnosis




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