Visuospatial functioning is associated with sleep disturbance and hallucinations in nondemented patients with Parkinson’s disease

Krista Specketer, Cyrus P. Zabetian, Karen L. Edwards, Lu Tian, Joseph F. Quinn, Amie L. Peterson-Hiller, Kathryn A. Chung, Shu Ching Hu, Thomas J. Montine, Brenna A. Cholerton

Research output: Contribution to journalArticlepeer-review

4 Scopus citations


Introduction: Cognitive impairment is a common symptom of Parkinson’s disease (PD) associated with reduced quality of life and a more severe disease state. Previous research has shown an association between visuospatial dysfunction and worse disease course; however, it is not clear whether this is separable from executive dysfunction and/or dementia. This study sought to determine whether distinct cognitive factors could be measured in a large PD cohort, and if those factors were differentially associated with other PD-related features, specifically to provide insight into visuospatial dysfunction. Methods: Non-demented participants with PD from the Pacific Udall Center were enrolled (n = 197). Co-participants (n = 104) completed questionnaires when available. Principal components factor analysis (PCFA) was utilized to group the neuropsychological test scores into independent factors by considering those with big factor loading (≥.40). Linear and logistic regression analyses were performed to examine the relationship between the cognitive factors identified in the PCFA and other clinical features of PD. Results: Six factors were extracted from the PCFA: 1) executive/processing speed, 2) visual learning & memory/visuospatial, 3) auditory working memory, 4) contextual verbal memory, 5) semantic learning & memory, and 6) visuospatial. Motor severity (p = 0.001), mood (p < 0.001), and performance on activities of daily living scores (informant: p < 0.001, patient: p = 0.009) were primarily associated with frontal and executive factors. General sleep disturbance (p < 0.006) and hallucinations (p = 0.002) were primarily associated with visuospatial functioning and visual learning/memory. Conclusions: Motor symptoms, mood, and performance on activities of daily living were primarily associated with frontal/executive factors. Sleep disturbance and hallucinations were associated with visuospatial functioning and visual learning/memory only, over and above executive functioning and regardless of cognitive disease severity. These findings support that visuospatial function in PD may indicate a more severe disease course, and that symptom management should be guided accordingly.

Original languageEnglish (US)
Pages (from-to)803-813
Number of pages11
JournalJournal of Clinical and Experimental Neuropsychology
Issue number8
StatePublished - Sep 14 2019


  • Aging
  • Parkinson’s disease
  • cognition
  • neuropsychological assessment

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Clinical Psychology
  • Neurology
  • Clinical Neurology


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