Progression of Parkinsonism and Loss of Cognitive Function in Alzheimer Disease

Abstract
SIGNS OF parkinsonism are common in Alzheimer disease (AD), but their relation to the principal manifestation of the disease, progressive cognitive decline, has been controversial. Several cross-sectional studies have found greater cognitive impairment, on average, in persons with parkinsonian signs compared with those without them,1-10 but evidence of this association in other studies has been mixed11,12 or absent.13,14 Some longitudinal studies have found that the presence of parkinsonism at the initial evaluation, or at some other specified point, is associated with more rapid cognitive decline.10,15,16 Other longitudinal studies, however, have obtained mixed14,17 or null5,18-20 results.

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