TY  - JOUR
AU  - Kalbe, Elke
AU  - Folkerts, Ann-Kristin
AU  - Witt, Karsten
AU  - Buhmann, Carsten
AU  - Liepelt-Scarfone, Inga
TI  - 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.
JO  - Journal of neurology
VL  - 271
IS  - 11
SN  - 0367-004X
CY  - [Darmstadt]
PB  - Steinkopff
M1  - DZNE-2025-00088
SP  - 7330 - 7357
PY  - 2024
AB  - 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.
KW  - Humans
KW  - Cognitive Dysfunction: etiology
KW  - Cognitive Dysfunction: therapy
KW  - Cognitive Dysfunction: diagnosis
KW  - Germany
KW  - Mood Disorders: etiology
KW  - Mood Disorders: therapy
KW  - Mood Disorders: diagnosis
KW  - Neurology: standards
KW  - Parkinson Disease: complications
KW  - Parkinson Disease: therapy
KW  - Parkinson Disease: diagnosis
KW  - Practice Guidelines as Topic: standards
KW  - Societies, Medical: standards
KW  - Review Literature as Topic
KW  - Anxiety (Other)
KW  - Dementia (Other)
KW  - Depression (Other)
KW  - Guideline (Other)
KW  - Mild cognitive impairment (Other)
KW  - Parkinson’s disease (Other)
LB  - PUB:(DE-HGF)16
C6  - pmid:39120709
C2  - pmc:PMC11561078
DO  - DOI:10.1007/s00415-024-12503-0
UR  - https://pub.dzne.de/record/275853
ER  -