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Objectives: Parkinsonian syndromes are disabling neurodegenerative diseases resulting in reduced muscle function/performance and sarcopenia, but clinical manifestations could be systemic, including deterioration of cognitive function. As studies have reported an association between muscle dysfunction and cognitive decline yet no information on these syndromes is available, we investigated the relationship between sarcopenia, its components, and cognitive function, fatigue, and quality of life (QoL)., Methods: Consecutive patients affected by parkinsonian syndromes were assessed for the presence of sarcopenia using the European Working Group on Sarcopenia in Older People-2 algorithm: low strength (handgrip strength: <27 kg [men]; <16 kg [women]) and low appendicular skeletal muscle index by impedance (<7.0 kg/m 2 [men]; <6.0 kg/m 2 [women]). Cognitive function was evaluated using the Montreal Cognitive Assessment, the Mini Mental State Examination and the Frontal Assessment Battery. Fatigue and QoL were assessed using the 16-item Parkinson's Disease Fatigue Scale and the 39-item Parkinson's Disease Questionnaire, respectively., Results: In total, 314 patients were included: 198 presented with low strength (63.0% probable sarcopenia); 68 (21.7%) of these were diagnosed with sarcopenia. After adjusting for multiple confounders, we observed a significant effect (poorer score) of both low strength only and sarcopenia on Montreal Cognitive Assessment, Mini Mental State Examination, and QoL. Only reduced muscle strength had a relevant impact on the outcomes considered., Conclusions: Sarcopenia is associated with worse cognitive functions and QoL in patients with parkinsonian syndromes, with muscle dysfunction playing a major role. The prognostic impact of sarcopenia and its components should be addressed in prospective studies., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Background: The rates of cognitive decline in patients with Parkinson's disease (PD) are higher than in the general population. Age and disease duration have been associated with increasing rates of dementia in PD. However, the role of other factors including gender has been poorly investigated. We investigated the relationship between dementia and gender along with other established risk factors, such as age and disease duration., Methods: We conducted a cross-sectional retrospective study including all consecutive patients diagnosed with idiopathic PD attending a single out-patient tertiary clinic over an 18-year period (1995-2013). Dementia was diagnosed according to DSM-IV criteria., Results: Prevalence of dementia was 11.5% (95%CI, 10.8-12.3) and 13.5% (95%CI, 12.7-14.5) in the whole population (N = 6599) and in those aged ≥60 years (N = 5373), respectively. Age and disease duration were independently associated with dementia, and the latter was associated with dementia up to 84 years of age. Male gender was an independent risk factor. In addition, while the rate of dementia increased in males over all age strata, we found that in females prevalence began to increase steadily after the age of 65 years, reaching male estimates only after 80 years of age. Higher rates in male gender were observed between 60 and 80 years of age., Conclusion: Age and PD duration are confirmed risk factors for dementia. However, disease duration appeared to be a less important factor in cognitive decline in patients aged ≥85 years. As opposed to gender-specific estimates in the general population, male gender is likely associated with higher rates of dementia in PD patients., (Copyright © 2016 Elsevier Ltd. All rights reserved.)