search for




 

Risk Factors for Cognitive Impairment in Patient with Parkinson’s Disease Treated with Levodopa
Korean J Clin Pharm 2018;28(4):285-292
Published online December 31, 2018
© 2018 Korean College of Clinical Pharmacy.

Kyung Sook Kim1,2, Kyung Eun Lee2*, and Myung Koo Lee2*

1Department of Clinical Pharmacy, Chungbuk National University Hospital, Cheongju 28644, Republic of Korea
2Department of Pharmacy, College of Pharmacy, Chungbuk National University, Cheongju 28160, Republic of Korea
Correspondence to: Myung Koo Lee, Department of Pharmacy, College of Pharmacy, Chungbuk National University, 194-21, Osongsaemyung 1-ro, Osong, Heungduk-gu, Cheongju 28160, Republic of Korea Tel: +82-43-261-2822, Fax: +82-43-268-2732
E-mail: myklee@cbnu.ac.kr
Co-correspondence to: Kyung Eun Lee, Department of Pharmacy, College of Pharmacy, Chungbuk National University, 194-21, Osongsaemyung 1-ro, Osong, Heungduk-gu, Cheongju 28160, Republic of Korea Tel: +82-43-261-3590, Fax: +82-43-268-2732
E-mail: kaylee@cbnu.ac.kr
Received July 27, 2018; Revised October 12, 2018; Accepted October 29, 2018.
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Background: Long-term levodopa therapy relieves the motor dysfunction associated with Parkinson’s disease (PD), but has various effects on non-motor symptoms, including cognitive dysfunction, hallucinations, and affective disorders, and can exacerbate certain aspects of dementia-like cognitive dysfunction. Here, we investigated the relationship between levodopa treatment and development of dementia in patients with PD.
Methods: This retrospective study analyzed 76 consecutive patients with PD who had taken levodopa between 2011 and 2015. The participants were initially free of dementia and had initial daily levodopa doses of below 600 mg. Patients who did and did not develop comorbid dementia were compared in terms of potential predictor variables, including PD onset age, sex, levodopa doses, and non-dementia comorbidities.
Results: Of the 76 patients, 21 (27.6%) developed dementia, which was followed by hallucinations and insomnia. The independent predictors of incident dementia were PD onset age and second-year and third-year average levodopa doses that were higher than the first-year average levodopa dose. Patients who developed dementia had significantly higher average daily levodopa doses and levodopa dose increases over the 6-year treatment period than those who did not develop dementia. In addition, patients with higher levodopa doses were more likely to experience hallucinations.
Conclusion: These results suggest that increases in levodopa doses may be associated with a greater risk of cognitive impairment in patients with PD. Therefore, motor and cognitive functions and levodopa dose increases should be evaluated regularly during long-term levodopa therapy in patients with PD.
Keywords : Parkinson disease, levodopa, cognitive dysfunction, dementia


December 2018, 28 (4)
Full Text(PDF) Free

Social Network Service
Services

Cited By Articles
  • CrossRef (0)

Funding Information
  • National Research Foundation of Korea(NRF)
      10.13039/501100003725
      2013R1A1A2058230, 2015-2016; 2016R1D1A3B03930722, 2016-2017