Dementia – The real problem for patients with Parkinson's disease

Parkinson's disease (PD) is meanwhile not only recognised as a disorder affecting the extrapyramidal motor system but apparently patients frequently experience non-motor symptoms, such as dementia, depression, sleep disorders, pain, autonomic and sensory dysfunction. New studies suggest that cognitive impairment or dementia would develop in each PD patient if lifetime is long enough. As these symptoms often have a greater impact on patients’ quality of life than motor symptoms, worsen the prognosis and increase the personal and socioeconomic burden of PD, a major focus of prevention, recognition and treatment is mandatory and might directly improve patients’ health related quality of life. Dementia associated with PD (PDD) and dementia with Lewy bodies (DLB) are likely to be part of the same disease entity and it has been shown that the cholinergic deficits are even greater than in Alzheimer's disease. Rivastigmine as a cholinesterase inhibitor provided significant benefits on cognition in comparison to placebo without worsening of parkinsonian symptoms in patients suffering from PDD and DLB.