{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,14]],"date-time":"2026-05-14T23:58:24Z","timestamp":1778803104060,"version":"3.51.4"},"reference-count":48,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T00:00:00Z","timestamp":1730851200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Aging Neurosci."],"abstract":"<jats:sec><jats:title>Background<\/jats:title><jats:p>Parkinson's disease psychosis (PDPsy) is associated with increased nursing home placement and mortality and is closely linked with cognitive dysfunction.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>Assess the clinical and cognitive features associated with PDPsy in patients without dementia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>We prospectively recruited people with Parkinson's disease (PwP) without dementia for a 3-year, longitudinal study at an outpatient movement disorders clinic. Participants completed annual visits involving assessment of motor and non-motor symptoms including neuropsychological testing. PDPsy was defined as the recurring presence of visual illusions, sense of presence, hallucinations, or delusions for at least 1 month. Using generalized estimating equations, we conducted two sets of analyses to separately assess the clinical and the cognitive predictors of PDPsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>We enrolled 105 participants. At baseline, mean age was 67.8 (SD = 8.0), median disease duration was 4.9 years (IQR: 3.4\u20137.7), and mean MoCA was 24.8 (SD = 2.3). Prevalence of PDPsy increased over 3 years from 31% (<jats:italic>n<\/jats:italic> = 32) to 39% (<jats:italic>n<\/jats:italic> = 26). Forty-five participants (43%) experienced PDPsy. Visual illusions were most common (70%, <jats:italic>n<\/jats:italic> = 84), followed by hallucinations (58.3%, <jats:italic>n<\/jats:italic> = 70). In multivariate analysis, of the clinical variables, only depressive symptoms [OR 1.09, 95% CI: (1.03, 1.16), <jats:italic>p<\/jats:italic> = 0.004] increased the odds of PDPsy; of the cognitive variables, only Trail Making Test B-A scores [OR 1.43, 95% CI: (1.06, 1.93), <jats:italic>p<\/jats:italic> = 0.018] significantly increased the odds of PDPsy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>In PwP without dementia, depressive symptoms were associated with increased risk of PDPsy. Executive\/attentional dysfunction was also associated with PDPsy and may mark the transition from isolated minor hallucinations to more complex psychotic symptoms.<\/jats:p><\/jats:sec>","DOI":"10.3389\/fnagi.2024.1463426","type":"journal-article","created":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T04:29:22Z","timestamp":1730867362000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":5,"title":["Clinical and cognitive features associated with psychosis in Parkinson's disease: a longitudinal study"],"prefix":"10.3389","volume":"16","author":[{"given":"Joseph L.","family":"Flanigan","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Madaline B.","family":"Harrison","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"James T.","family":"Patrie","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Binit B.","family":"Shah","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Scott A.","family":"Sperling","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kathryn A.","family":"Wyman-Chick","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"William Alex","family":"Dalrymple","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matthew J.","family":"Barrett","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2024,11,6]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"595","DOI":"10.1001\/archneur.56.5.595","article-title":"Prevalence and clinical correlates of psychotic symptoms in Parkinson disease: a community-based study","volume":"56","author":"Aarsland","year":"1999","journal-title":"Archiv. Neurol."},{"key":"B2","doi-asserted-by":"publisher","first-page":"32","DOI":"10.1016\/j.jns.2015.06.037","article-title":"Cognitive and neuroanatomical correlates of neuropsychiatric symptoms in Parkinson's disease: a systematic review","volume":"356","author":"Alzahrani","year":"2015","journal-title":"J. Neurol. Sci."},{"key":"B3","doi-asserted-by":"publisher","first-page":"e1618","DOI":"10.1212\/WNL.0000000000005421","article-title":"Baseline symptoms and basal forebrain volume predict future psychosis in early Parkinson disease","volume":"90","author":"Barrett","year":"2018","journal-title":"Neurology"},{"key":"B4","doi-asserted-by":"publisher","first-page":"56","DOI":"10.1016\/j.parkreldis.2017.07.011","article-title":"Characteristics, correlates, and assessment of psychosis in Parkinson disease without dementia","volume":"43","author":"Barrett","year":"2017","journal-title":"Parkinson. Relat. Disord."},{"key":"B5","doi-asserted-by":"publisher","first-page":"438","DOI":"10.1111\/ene.14576","article-title":"Minor hallucinations reflect early gray matter loss and predict subjective cognitive decline in Parkinson's disease","volume":"28","author":"Bejr-kasem","year":"2021","journal-title":"Eur. J. Neurol."},{"key":"B6","doi-asserted-by":"publisher","first-page":"641","DOI":"10.1136\/jnnp.2006.100073","article-title":"Cortical cholinergic denervation is associated with depressive symptoms in Parkinson's disease and parkinsonian dementia","volume":"78","author":"Bohnen","year":"2007","journal-title":"J. Neurol. Neurosurg. Psychiat."},{"key":"B7","doi-asserted-by":"publisher","first-page":"121","DOI":"10.1007\/s00441-004-0956-9","article-title":"Stages in the development of Parkinson's disease-related pathology","volume":"318","author":"Braak","year":"2004","journal-title":"Cell Tissue Res."},{"key":"B8","doi-asserted-by":"publisher","first-page":"1404","DOI":"10.1212\/01.WNL.0000158422.41380.82","article-title":"Cognitive status correlates with neuropathologic stage in Parkinson disease","volume":"64","author":"Braak","year":"2005","journal-title":"Neurology"},{"key":"B9","volume-title":"Hopkins Verbal Learning Test-Revised","author":"Brandt","year":"1997"},{"key":"B10","doi-asserted-by":"publisher","first-page":"189","DOI":"10.1093\/arclin\/acs115","article-title":"Trail making test: regression-based norms for the Portuguese population","volume":"28","author":"Cavaco","year":"2013","journal-title":"Archiv. Clin. Neuropsychol"},{"key":"B11","doi-asserted-by":"publisher","first-page":"33","DOI":"10.1016\/j.smrv.2016.08.001","article-title":"Systematic review of the literature on disorders of sleep and wakefulness in Parkinson's disease from 2005\u20132015","volume":"35","author":"Chahine","year":"2017","journal-title":"Sleep Med. Rev"},{"key":"B12","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1016\/S0140-6736(13)62106-6","article-title":"Pimavanserin for patients with Parkinson's disease psychosis: a randomised, placebo-controlled phase 3 trial","volume":"383","author":"Cummings","year":"2014","journal-title":"Lancet"},{"key":"B13","doi-asserted-by":"publisher","first-page":"1717","DOI":"10.1212\/WNL.0b013e3181fc29c9","article-title":"The MoCA: well-suited screen for cognitive impairment in Parkinson disease","volume":"75","author":"Dalrymple-Alford","year":"2010","journal-title":"Neurology"},{"key":"B14","doi-asserted-by":"publisher","first-page":"225","DOI":"10.1002\/mdc3.12381","article-title":"Affective correlates of psychosis in Parkinson's disease","volume":"4","author":"Factor","year":"2017","journal-title":"Mov. Disord. Clin. Pract."},{"key":"B15","doi-asserted-by":"publisher","first-page":"18","DOI":"10.1017\/S1092852900017284","article-title":"Psychosis in Parkinson's disease: phenomenology, frequency, risk factors, and current understanding of pathophysiologic mechanisms","volume":"13","author":"F\u00e9nelon","year":"2008","journal-title":"CNS Spectr"},{"key":"B16","doi-asserted-by":"publisher","first-page":"12","DOI":"10.1016\/j.jns.2009.08.014","article-title":"Epidemiology of psychosis in Parkinson's disease","volume":"289","author":"F\u00e9nelon","year":"2010","journal-title":"J. Neurol. Sci."},{"key":"B17","doi-asserted-by":"publisher","first-page":"733","DOI":"10.1093\/brain\/123.4.733","article-title":"Hallucinations in Parkinson's disease prevalence, phenomenology and risk factors","volume":"123","author":"F\u00e9nelon","year":"2000","journal-title":"Brain"},{"key":"B18","doi-asserted-by":"publisher","first-page":"763","DOI":"10.1002\/mds.22839","article-title":"The changing face of Parkinson's disease-associated psychosis: a cross-sectional study based on the new NINDS-NIMH criteria","volume":"25","author":"Fenelon","year":"2010","journal-title":"Mov. Disord"},{"key":"B19","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1038\/nrneurol.2016.200","article-title":"The psychosis spectrum in Parkinson disease","volume":"13","author":"Ffytche","year":"2017","journal-title":"Nat. Rev. Neurol."},{"key":"B20","doi-asserted-by":"publisher","first-page":"996","DOI":"10.1001\/archneurol.2010.166","article-title":"12-year population-based study of psychosis in Parkinson disease","volume":"67","author":"Forsaa","year":"2010","journal-title":"Archiv. Neurol."},{"key":"B21","doi-asserted-by":"publisher","first-page":"3299","DOI":"10.1093\/brain\/awr225","article-title":"Testing an aetiological model of visual hallucinations in Parkinson's disease","volume":"134","author":"Gallagher","year":"2011","journal-title":"Brain"},{"key":"B22","doi-asserted-by":"publisher","first-page":"626","DOI":"10.1002\/gps.3869","article-title":"Frequency, prevalence, incidence and risk factors associated with visual hallucinations in a sample of patients with Parkinson's disease: a longitudinal 4-year study","volume":"28","author":"Gibson","year":"2013","journal-title":"Int. J. Geriatr. Psychiat."},{"key":"B23","doi-asserted-by":"publisher","first-page":"2422","DOI":"10.1212\/WNL.0000000000001684","article-title":"Depression and subsequent risk of Parkinson disease","volume":"84","author":"Gustafsson","year":"2015","journal-title":"Neurology"},{"key":"B24","volume-title":"Revised Comprehensive Norms for an Expanded Halstead-Reitan Battery: Demographically Adjusted Neuropsychological Norms for African American and Caucasian Adults","author":"Heaton","year":"2004"},{"key":"B25","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1080\/13854040490524137","article-title":"Demographic influences on baseline and derived scores from the trail making test in healthy older Australian adults","volume":"19","author":"Hester","year":"2005","journal-title":"Clin. Neuropsychol"},{"key":"B26","first-page":"230","article-title":"Derived trail making test indices: a preliminary report","volume":"7","author":"Lamberty","year":"1994","journal-title":"Neuropsychiat. Neuropsychol. Behav. Neurol."},{"key":"B27","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1016\/j.parkreldis.2016.12.025","article-title":"Pattern of cognitive impairment in patients with Parkinson's disease and psychosis: a critical review","volume":"37","author":"Lenka","year":"2017","journal-title":"Parkinson. Relat. Disord."},{"key":"B28","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.parkreldis.2015.11.018","article-title":"Interactions of visual hallucinations, rapid eye movement sleep behavior disorder and cognitive impairment in Parkinson's disease: a review","volume":"22","author":"Lenka","year":"2016","journal-title":"Parkinson. Relat. Disord"},{"key":"B29","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1212\/WNL.0000000000007913","article-title":"Minor hallucinations in Parkinson disease: a subtle symptom with major clinical implications","volume":"93","author":"Lenka","year":"2019","journal-title":"Neurology"},{"key":"B30","doi-asserted-by":"publisher","first-page":"2785","DOI":"10.1002\/mds.23411","article-title":"Neuropsychological correlates of mild to severe hallucinations in Parkinson's disease","volume":"25","author":"Llebaria","year":"2010","journal-title":"Mov. Disord."},{"key":"B31","doi-asserted-by":"publisher","first-page":"1777","DOI":"10.1002\/mds.26321","article-title":"Altered brain network centrality in depressed Parkinson's disease patients","volume":"30","author":"Lou","year":"2015","journal-title":"Mov. Disord."},{"key":"B32","doi-asserted-by":"publisher","first-page":"123","DOI":"10.1097\/JGP.0b013e31821f1b41","article-title":"Prevalence of psychotic symptoms in a community-based Parkinson disease sample","volume":"20","author":"Mack","year":"2012","journal-title":"Am. J. Geriatr. Psychiatr."},{"key":"B33","doi-asserted-by":"publisher","first-page":"559","DOI":"10.1016\/S1474-4422(18)30127-3","article-title":"Risk factors for non-motor symptoms in Parkinson's disease","volume":"17","author":"Marinus","year":"2018","journal-title":"Lancet Neurol"},{"key":"B34","doi-asserted-by":"publisher","first-page":"293","DOI":"10.1212\/01.WNL.0000129843.15756.A3","article-title":"Psychiatric comorbidities in patients with Parkinson disease and psychosis","volume":"63","author":"Marsh","year":"2004","journal-title":"Neurology"},{"key":"B35","doi-asserted-by":"publisher","first-page":"76","DOI":"10.1136\/jnnp-2011-300043","article-title":"Psychosis associated to Parkinson's disease in the early stages: relevance of cognitive decline and depression","volume":"83","author":"Morgante","year":"2012","journal-title":"J. Neurol. Neurosurg. Psychiatr."},{"key":"B36","doi-asserted-by":"publisher","first-page":"711","DOI":"10.1016\/j.sleep.2011.01.015","article-title":"Utility of the REM sleep behavior disorder screening questionnaire (RBDSQ) in Parkinson's disease patients","volume":"12","author":"Nomura","year":"2011","journal-title":"Sleep Med."},{"key":"B37","doi-asserted-by":"publisher","first-page":"538","DOI":"10.1111\/ane.13380","article-title":"Risk factors for minor hallucinations in Parkinson's disease","volume":"143","author":"Omoto","year":"2021","journal-title":"Acta Neurol. Scand"},{"key":"B38","doi-asserted-by":"publisher","first-page":"135","DOI":"10.1038\/s41582-023-00918-8","article-title":"Parkinson disease psychosis: from phenomenology to neurobiological mechanisms","volume":"20","author":"Pagonabarraga","year":"2024","journal-title":"Nat. Rev. Neurol"},{"key":"B39","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1002\/mds.26432","article-title":"Minor hallucinations occur in drug-naive Parkinson's disease patients, even from the premotor phase","volume":"31","author":"Pagonabarraga","year":"2016","journal-title":"Mov. Disord."},{"key":"B40","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1017\/S1355617703910022","article-title":"Prodromal frontal\/executive dysfunction predicts incident dementia in Parkinson's disease","volume":"9","author":"Paulwoods","year":"2003","journal-title":"J. Int. Neuropsychol. Soc."},{"key":"B41","doi-asserted-by":"publisher","first-page":"1061","DOI":"10.1002\/mds.21382","article-title":"Diagnostic criteria for psychosis in Parkinson's disease: report of an NINDS, NIMH work group","volume":"22","author":"Ravina","year":"2007","journal-title":"Mov. Disord."},{"key":"B42","doi-asserted-by":"publisher","first-page":"2349","DOI":"10.1523\/JNEUROSCI.5587-06.2007","article-title":"Dissociable intrinsic connectivity networks for salience processing and executive control","volume":"27","author":"Seeley","year":"2007","journal-title":"J. Neurosci."},{"key":"B43","doi-asserted-by":"publisher","first-page":"15003","DOI":"10.1038\/npjparkd.2015.3","article-title":"Abnormal connectivity between the default mode and the visual system underlies the manifestation of visual hallucinations in Parkinson's disease: a task-based fMRI study","volume":"1","author":"Shine","year":"2015","journal-title":"NPJ Parkinson's Dis."},{"key":"B44","doi-asserted-by":"publisher","first-page":"58","DOI":"10.1016\/j.pneurobio.2014.01.004","article-title":"Tricks of the mind: visual hallucinations as disorders of attention","volume":"116","author":"Shine","year":"2014","journal-title":"Progr. Neurobiol."},{"key":"B45","doi-asserted-by":"publisher","first-page":"61","DOI":"10.1097\/WNF.0000000000000384","article-title":"Effect of antidepressants on psychotic symptoms in Parkinson disease: a review of case reports and case series","volume":"43","author":"Sid-Otmane","year":"2020","journal-title":"Clin. Neuropharmacol."},{"key":"B46","doi-asserted-by":"publisher","first-page":"2649","DOI":"10.1002\/mds.23429","article-title":"Systematic review of levodopa dose equivalency reporting in Parkinson's disease","volume":"25","author":"Tomlinson","year":"2010","journal-title":"Mov. Disord."},{"key":"B47","volume-title":"Wechsler Adult Intelligence Scale, 4th Edn","author":"Wechsler","year":"2008"},{"key":"B48","doi-asserted-by":"publisher","first-page":"2127","DOI":"10.1038\/s41598-017-02127-y","article-title":"Aberrant intra- and internetwork functional connectivity in depressed Parkinson's disease","volume":"7","author":"Wei","year":"2017","journal-title":"Sci. Rep."}],"container-title":["Frontiers in Aging Neuroscience"],"original-title":[],"link":[{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2024.1463426\/full","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,6]],"date-time":"2024-11-06T04:29:26Z","timestamp":1730867366000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.frontiersin.org\/articles\/10.3389\/fnagi.2024.1463426\/full"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,11,6]]},"references-count":48,"alternative-id":["10.3389\/fnagi.2024.1463426"],"URL":"https:\/\/doi.org\/10.3389\/fnagi.2024.1463426","relation":{},"ISSN":["1663-4365"],"issn-type":[{"value":"1663-4365","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,11,6]]},"article-number":"1463426"}}