{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T16:49:00Z","timestamp":1789663740200,"version":"4.0.1"},"reference-count":43,"publisher":"BMJ","issue":"9","license":[{"start":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T00:00:00Z","timestamp":1681948800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100012317","name":"UCLH Biomedical Research Centre","doi-asserted-by":"publisher","award":["BRC302\/NS\/RW\/101410"],"award-info":[{"award-number":["BRC302\/NS\/RW\/101410"]}],"id":[{"id":"10.13039\/501100012317","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100010269","name":"Wellcome Trust","doi-asserted-by":"publisher","award":["205167\/Z\/16\/Z"],"award-info":[{"award-number":["205167\/Z\/16\/Z"]}],"id":[{"id":"10.13039\/100010269","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["J Neurol Neurosurg Psychiatry"],"accepted":{"date-parts":[[2023,3,30]]},"published-print":{"date-parts":[[2023,9]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Dementia is a common and devastating symptom of Parkinson\u2019s disease (PD). Visual function and retinal structure are both emerging as potentially predictive for dementia in Parkinson\u2019s but lack longitudinal evidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We prospectively examined higher order vision (skew tolerance and biological motion) and retinal thickness (spectral domain optical coherence tomography) in 100 people with PD and 29 controls, with longitudinal cognitive assessments at baseline, 18 months and 36 months. We examined whether visual and retinal baseline measures predicted longitudinal cognitive scores using linear mixed effects models and whether they predicted onset of dementia, death and frailty using time-to-outcome methods.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Patients with PD with poorer baseline visual performance scored lower on a composite cognitive score (\u03b2=0.178, SE=0.05, p=0.0005) and showed greater decreases in cognition over time (\u03b2=0.024, SE=0.001, p=0.013). Poorer visual performance also predicted greater probability of dementia (\u03c7\u00b2 (1)=5.2, p=0.022) and poor outcomes (\u03c7\u00b2 (1) =10.0, p=0.002). Baseline retinal thickness of the ganglion cell\u2013inner plexiform layer did not predict cognitive scores or change in cognition with time in PD (\u03b2=\u22120.013, SE=0.080, p=0.87; \u03b2=0.024, SE=0.001, p=0.12).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In our deeply phenotyped longitudinal cohort, visual dysfunction predicted dementia and poor outcomes in PD. Conversely, retinal thickness had less power to predict dementia. This supports mechanistic models for Parkinson\u2019s dementia progression with onset in cortical structures and shows potential for visual tests to enable stratification for clinical trials.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/jnnp-2023-331083","type":"journal-article","created":{"date-parts":[[2023,4,20]],"date-time":"2023-04-20T13:25:26Z","timestamp":1681997126000},"page":"742-750","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":33,"title":["Visual dysfunction is a better predictor than retinal thickness for dementia in Parkinson\u2019s 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