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Authors
Advisor(s)
Abstract(s)
O envelhecimento populacional crescente e o inerente aumento da incidência de
doenças neurodegenerativas que lhe estão associadas, como a Doença de Parkinson
(DP) são uma realidade cada vez mais frequente na prática clínica. A DP é a segunda
doença neurodegenerativa mais comum nos idosos, afectando cerca de 1% da população
mundial. Além dos sintomas motores clássicos (tremor, rigidez, bradicinésia e
instabilidade postural), a DP acompanha-se de alterações cognitivas que têm sido
objecto de grande produção científica nas últimas décadas. São habituais alterações em
diversos domínios cognitivos como as funções executivas, a linguagem, as habilidades
visuo-perceptivas e a memória, mesmo em estádios iniciais da doença e em doentes não
demenciados. Apesar da demência associada à DP (PDD) ser menos frequente, sabe-se
que o risco relativo de desenvolver demência nos doentes de Parkinson é superior ao da
população em geral. Clinicamente, a PDD caracteriza-se por uma síndrome disfuncional
executiva predominante, associando-se frequentemente a várias alterações psiquiátricas
como a depressão, a ansiedade e os sintomas psicóticos.
As alterações cognitivas da DP e as alterações psiquiátricas associadas complicam o
tratamento dos sintomas motores, conduzindo a uma disfunção progressiva. Além de
aumentarem a morbilidade e a mortalidade dos doentes, constituem um factor de risco
para a institucionalização e têm implicações na qualidade de vida dos doentes e dos seus
cuidadores.
Este trabalho constitui uma revisão das bases neuroquímicas e neuropatológicas, da
epidemiologia, dos factores de risco, das características clínicas, do diagnóstico e do
tratamento da disfunção cognitiva e da demência na Doença de Parkinson (PDD). Revê-se, igualmente, as alterações psiquiátricas e os aspectos sociais ligados à disfunção
cognitiva na DP.
Growing ageing population and related neurodegenerative disorders, such as Parkinson's disease (PD) are realities increasingly common in clinical practice. PD is the second most common neurodegenerative disorder among elderly, affecting 1% of world population. In addition to motor symptoms (tremor, rigidity, bradykinesia and postural instability), DP is frequently associated with cognitive dysfunction. In recent decades this aspect was the subject of several studies. Impairment in different cognitive domains such as executive functions, language, visuoperceptive skills and memory occurs frequently in the early stages of the disease and in nondemented patients. Although Parkinson disease dementia (PDD) is less frequent, risk for developing dementia is greater than the prevalence rate in general population. Clinically, dementia in PD is characterised by a predominant dysexecutive syndrome accompanied frequently by neuropsychiatric symptoms such as depression, anxiety and psychosis. Cognitive dysfunction and neuropsychiatric related symptoms often limit effective treatment of motor symptoms and lead to progressive disability. These clinical features increase morbidity and mortality of patients, constitute a risk factor for nursing home admission and have been associated with reduced patient and caregiver quality of life. In this work, the characteristics of cognitive dysfunction in PD are reviewed including neurochemical deficits, neuropathology, epidemiology, risk factors, clinical features, diagnosis and treatment. Related neuropsychiatric symptoms and social aspects are also reviewed.
Growing ageing population and related neurodegenerative disorders, such as Parkinson's disease (PD) are realities increasingly common in clinical practice. PD is the second most common neurodegenerative disorder among elderly, affecting 1% of world population. In addition to motor symptoms (tremor, rigidity, bradykinesia and postural instability), DP is frequently associated with cognitive dysfunction. In recent decades this aspect was the subject of several studies. Impairment in different cognitive domains such as executive functions, language, visuoperceptive skills and memory occurs frequently in the early stages of the disease and in nondemented patients. Although Parkinson disease dementia (PDD) is less frequent, risk for developing dementia is greater than the prevalence rate in general population. Clinically, dementia in PD is characterised by a predominant dysexecutive syndrome accompanied frequently by neuropsychiatric symptoms such as depression, anxiety and psychosis. Cognitive dysfunction and neuropsychiatric related symptoms often limit effective treatment of motor symptoms and lead to progressive disability. These clinical features increase morbidity and mortality of patients, constitute a risk factor for nursing home admission and have been associated with reduced patient and caregiver quality of life. In this work, the characteristics of cognitive dysfunction in PD are reviewed including neurochemical deficits, neuropathology, epidemiology, risk factors, clinical features, diagnosis and treatment. Related neuropsychiatric symptoms and social aspects are also reviewed.
Description
Keywords
Doença de Parkinson Doença de Parkinson - Aspectos neuropsiquiátricos Doença de Parkinson - Défice cognitivo Doença de Parkinson - Demência Doença de Parkinson - Aspectos sociais
Citation
Publisher
Universidade da Beira Interior