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Publication Date

2010-05-14

Availability

UM campus only

Degree Type

Dissertation

Degree Name

Doctor of Philosophy (PHD)

Department

Psychology (Arts and Sciences)

Date of Defense

2009-12-02

First Committee Member

Bonnie E. Levin

Second Committee Member

Philip M. McCabe

Third Committee Member

Matthias Siemer

Fourth Committee Member

Edward J. Green

Fifth Committee Member

Heather L. Katzen

Abstract

Parkinson's disease (PD) is the 14th leading cause of the death in the United States. There is a strong relationship between cognitive decline, subsequent dementia, and mortality in PD. Cognitive reserve contributes to the maintenance of cognitive functioning in old age. However, the importance of cognitive reserve in the clinical course of PD is largely unknown. The current study examined cognitive and psychosocial parameters and their effect on survival in PD. It was proposed that cognitive factors (most specifically, higher semantic fluency) and psychosocial factors (i.e., higher educational/occupational attainment, absence of threshold level depressive symptomatology, absence of a personal/familial psychiatric history, and having a spouse/life partner) will predict increased post-onset survival in PD. After obtaining informed consent, 192 PD participants underwent a 3-hour comprehensive neuropsychological evaluation, neurological examination, and interview. Results from a multivariate Cox proportional hazards model indicated that semantic fluency is predictive of post-onset survival in PD, independent of age of onset, disease duration at examination, gender, years of education, and disease stage. The present study did not find a relationship between psychosocial factors and post-onset survival in PD. These findings indicate that a brief assessment of semantic fluency, able to be obtained in a clinic in less than five minutes, may be a useful prognostic indicator of post-onset survival in PD.

Keywords

Parkinson's Disease; Mortality; Fluency

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