The diagnosis of dementia associated with Parkinson's Disease requires exclusion of other conditions which may mimic it.


Key requirements for dementia associated with Parkinson's disease:

(1) The patient has Parkinson's disease.

(2) The onset of the cognitive impairment is after the onset of the Parkinsonian motor symptoms.

(3) It shows "typical" features: insidious onset, slow progression, common deficits (with attention, executive, visuospatial functions) and behavioral features.


Other neurodegenerative disorders with parkinsonism:

(1) Dementia with Lewy Bodies

(2) progressive supranuclear palsy

(3) corticobasal degeneration


Concurrent dementia arising independently of the PD:

(1) Alzheimer's Disease

(2) vascular dementia


Consequence of Parkinson Disease therapy:

(1) adverse effect of dopaminergic agent

(2) drug interaction involving a PD medication

(3) adverse effects of an anticholinergic agent

(4) related to change in cognition while in an "off" period


Other potentially reversible cognitive impairment:

(1) major depression

(2) sleep deprivation

(3) delirium

(4) normal pressure hydrocephalus

(5) intracranial mass effect

(6) head trauma and/or subdural hematoma

(7) thyroid or other endocrine disorder

(8) nutritional deficiency

(9) toxic or hypoxic event

(10) adverse effect of non-PD medications


In the future advances in imaging techniques may be helpful when clinical findings are insufficient.


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