Journal Article

DZNE-2025-00088

http://join2-wiki.gsi.de/foswiki/pub/Main/Artwork/join2_logo100x88.png German Society of Neurology guidelines for the diagnosis and treatment of cognitive impairment and affective disorders in people with Parkinson's disease: new spotlights on diagnostic procedures and non-pharmacological interventions.

Kalbe, E. ; Folkerts, A.-K. ; Witt, K. ; Buhmann, C. ; Liepelt-Scarfone, I.DZNE* ; Group, G. P. G. (Collaboration Author)

2024
Steinkopff [Darmstadt]

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Please use a persistent id in citations: doi:10.1007/s00415-024-12503-0

Abstract: Cognitive impairment and dementia as well as affective disorders are common and debilitating syndromes that develop in people with Parkinson's disease (PwPD). The authors summarized recommendations for the 2023 updated German guidelines on 'Parkinson's disease' from the German Neurological Society (DGN), focusing on the diagnosis and treatment of these disorders.The recommendations were based on literature reviews, other relevant guidelines, and expert opinions.Measurements to assess cognitive and affective states were reviewed for psychometric properties, use in routine clinical practice, and availability in German. To improve mild cognitive impairment, cognitive training and physical aerobic training are recommended. To treat Parkinson's disease (PD)-related dementia, cognitive stimulation (as a non-pharmacological intervention) and acetylcholinesterase inhibitors (AChEIs, i.e., rivastigmine) are recommended. Cognitive behavioral therapy is recommended to treat depression, anxiety, and fear of progression. Physical interventions are recommended to treat depression, fatigue, and apathy. Optimized dopaminergic treatment is the first-line pharmacological strategy recommended to manage depression, apathy, anhedonia, fatigue, and mood swings. Major depression can be additionally treated using venlafaxine or desipramine, while moderate depression can be treated pharmacologically according to its clinical phenotype (psychomotor retardation or agitation) and comorbidities (e.g., sleep disturbances, pain). Venlafaxine and nortriptyline can be used to treat anhedonia, while citalopram can be used for anxiety.In addition to the updated pharmacological treatment options, new insights into recommendations for standardized diagnostics and non-pharmacological interventions were provided for the German health care system. However, more studies are needed to explore the full potential of non-pharmacological interventions to treat and prevent cognitive impairment and affective disorders.

Keyword(s): Humans (MeSH) ; Cognitive Dysfunction: etiology (MeSH) ; Cognitive Dysfunction: therapy (MeSH) ; Cognitive Dysfunction: diagnosis (MeSH) ; Germany (MeSH) ; Mood Disorders: etiology (MeSH) ; Mood Disorders: therapy (MeSH) ; Mood Disorders: diagnosis (MeSH) ; Neurology: standards (MeSH) ; Parkinson Disease: complications (MeSH) ; Parkinson Disease: therapy (MeSH) ; Parkinson Disease: diagnosis (MeSH) ; Practice Guidelines as Topic: standards (MeSH) ; Societies, Medical: standards (MeSH) ; Review Literature as Topic (MeSH) ; Anxiety ; Dementia ; Depression ; Guideline ; Mild cognitive impairment ; Parkinson’s disease

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Contributing Institute(s):

1. Parkinson Genetics (AG Gasser)

Research Program(s):

1. 353 - Clinical and Health Care Research (POF4-353) (POF4-353)

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Database coverage:
; ; ; BIOSIS Previews ; Biological Abstracts ; Clarivate Analytics Master Journal List ; Current Contents - Life Sciences ; DEAL Springer ; Ebsco Academic Search ; Essential Science Indicators ; IF >= 5 ; JCR ; Nationallizenz ; SCOPUS ; Science Citation Index Expanded ; Web of Science Core Collection

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