Diagnosis and Management of Cognitive Impairment in Parkinson's Disease

Originally considered a movement disorder that did not affect cognition, it is now understood that cognitive impairment is widespread among those with Parkinson's disease. Patients present with a variety of cognitive deficits, including executive dysfunction, visuospatial impairment, and memory loss. Neuropsychiatric symptoms are common, particularly psychosis, depression, and anxiety. Rivastigmine and donepezil have both been shown in large, blinded studies to slow the progression of dementia, although rivastigmine is the only medication approved by the United States Food and Drug Administration. Cognitive rehabilitation may be a safe alternative if medications are intolerable. Research is still needed at all levels to gain understanding of this disease process.