Identifying comorbidities and lifestyle factors contributing to the cognitive profile of early Parkinson’s disease

Abstract

Background: Identifying modifable risk factors for cognitive impairment in the early stages of Parkinson’s disease (PD) and estimating their impact on cognitive status may help prevent dementia (PDD) and the design of cognitive trials. Methods: Using a standard approach for the assessment of global cognition in PD and controlling for the efects of age, education and disease duration, we explored the associations between cognitive status, comorbidities, meta‑ bolic variables and lifestyle variables in 533 PD participants from the COPPADIS study. Results: Among the overall sample, 21% of participants were classifed as PD-MCI (n=114) and 4% as PDD (n=26). The prevalence of hypertension, diabetes and dyslipidemia was signifcantly higher in cognitively impaired patients while no between-group diferences were found for smoking, alcohol intake or use of supplementary vitamins. Bet‑ ter cognitive scores were signifcantly associated with regular physical exercise (p<0.05) and cognitive stimulation (<0.01). Cognitive performance was negatively associated with interleukin 2 (Il2) (p<0.05), Il6 (p<0.05), iron (p<0.05), and homocysteine (p<0.005) levels, and positively associated with vitamin B12 levels (p<0.005). Conclusions: We extend previous fndings regarding the positive and negative infuence of various comorbidities and lifestyle factors on cognitive status in early PD patients, and reinforce the need to identify and treat potentially