Parkinson’s disease (PD) is the second most common progressive neurodegenerative disorder mainly in middle-elderly population, which represents diverse nonmotor symptoms (NMS) besides such well-documented motor symptoms as bradykinesia, resting tremor, rigidity, and postural instability. With the advancement of aging trend worldwide, the global prevalence of PD is mounting up year after year. Nowadays, accumulating lines of studies have given a comprehensive and thorough coverage of motor symptoms in PD. Yet much less attention as compared has been paid to the nonmotor symptoms of PD, such as cognition deficits. Of note, a patient with PD who suffers from cognitive impairment may harbour a statistically significantly higher risk of progressing toward dementia, which negatively affects their life expectancy and daily functioning and overall lowers the global quality of life. Furthermore, it is a widely held view that cognitive dysfunction does not just occur in the late stage of PD. On the basis of numerous studies, mild cognitive impairment (MCI) is a harbinger of dementia in PD, which is observed as an intermediate state with considerable variability; some patients remain stable and some even revert to normal cognition. Considered that the timing, profile, and rate of cognitive impairment vary greatly among PD individuals, it is extremely urgent for researchers and clinicians alike to identify and predict future cognitive decline in this population. Simultaneously, early screening and canonical management of PD with cognitive deficits are very imperative to postpone the disease progression and improve the prognosis of patients. In our review, we focus on a description of cognitive decline in PD, expound emphatically the pathological mechanisms underlying cognition deficits in PD, then give a comprehensive overview of specific therapeutic strategies, and finally dissect what fresh insights may bring new exciting prospect for the subfield.

中文翻译：

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帕金森氏病的认知缺陷：机制和治疗

帕金森氏病（PD）是第二个最常见的进行性神经退行性疾病，主要发生在中老年人中，除了运动迟缓，静息性震颤，僵硬和姿势不稳等运动性症状外，它还表现出多种非运动性症状（NMS）。随着全球老龄化趋势的发展，PD的全球患病率逐年上升。如今，越来越多的研究对PD中的运动症状进行了全面而彻底的报道。与之相比，对PD的非运动性症状（例如认知障碍）的关注却要少得多。值得注意的是，患有认知障碍的PD患者在统计学上可能有更高的发展为痴呆的风险，这会对他们的预期寿命和日常工作产生负面影响，并整体上降低全球的生活质量。此外，人们普遍认为，认知功能障碍不仅发生在PD的晚期。在众多研究的基础上，轻度认知障碍（MCI）是PD痴呆的预兆，被认为是一种中间状态，具有很大的变异性。有些病人保持稳定，有些甚至恢复正常认知。考虑到PD个体之间认知障碍的时间，特征和发生率差异很大，研究人员和临床医生都非常迫切需要识别和预测该人群未来的认知能力下降。同时，早期筛查和规范治疗具有认知缺陷的PD对于推迟疾病进展和改善患者预后非常重要。在我们的综述中，我们着重于对PD认知能力下降的描述，着重阐述PD认知缺陷的潜在病理机制，然后对特定的治疗策略进行全面概述，最后剖析哪些新见解可能为该子领域带来新的令人兴奋的前景。