Fluctuations in attention

TLDR

Marked impairments in and fluctuation of attention are characteristic of dementia with Lewy bodies (DLB). The study aimed to compare impairments of attention and fluctuating attention in Parkinson’s disease and Parkinson’s disease dementia to better understand parkinsonian dementias. Researchers evaluated attention and fluctuating attention using the Cognitive Drug Research computerized battery in 278 participants (50 DLB, 48 PD dementia, 50 PD, 80 AD, 50 elderly controls) recruited from the Newcastle dementia register and the Stavanger PD register. Patients with DLB and PD dementia showed comparable impairments in reaction time, vigilance, and fluctuating attention, whereas DLB without parkinsonism was less impaired; PD patients had greater reaction time deficits than controls but did not exhibit fluctuating attention, indicating that attentional profiles of PD dementia and DLB with parkinsonism are similar and questioning arbitrary group distinctions.

Abstract

Marked impairments in and fluctuation of attention are characteristic of dementia with Lewy bodies (DLB). The comparative impairment of these cognitive domains in PD and PD dementia (PD dementia) has not been studied, and is important to the conceptual understanding of parkinsonian dementias.Detailed evaluations of attention and fluctuating attention (Cognitive Drug Research computerized battery) were undertaken in 278 subjects (50 DLB, 48 PD dementia, 50 PD, 80 AD, 50 elderly controls) from the Newcastle dementia register and the Stavanger PD register (controls, PD, and PD dementia patients were recruited from both centers). DLB, AD, PD, and PD dementia were diagnosed using operationalized criteria.Impairments in reaction time, vigilance, and fluctuating attention were comparable in patients with DLB and PD dementia, but were less substantially impaired in patients with DLB without parkinsonism. Patients with PD had significantly greater impairment of cognitive reaction time than elderly controls, and comparable impairments of cognitive reaction time to patients with AD. Patients with PD, however, did not exhibit fluctuation of attention.The profile of attentional impairments and fluctuating attention is similar in PD dementia and DLB with parkinsonism. The current findings do not support the current arbitrary distinctions between these patient groups. Importantly, patients with PD do not experience fluctuating attention.