The prevalence of dementia, assessed on the basis of the Wechsler scal
e (WAIS), was determined in a group of 88 patients with idiopathic Par
kinson's disease (PD) lasting longer than 4 years. In this group, 19 p
atients (22%) were diagnosed as demented. They were significantly olde
r at the time of evaluation (72.9+/-8.1 vs. 63.6+/-11.9), and also at
the onset of the disease (61.1+/-10.6 vs. 54.4+/-12.1) than nondemente
d patients. Their parkinsonism, as judged on the base of the Activity
of Daily Living Scale, was more pronounced(57.4+/-13.7 vs. 73.3+/-15.6
) and they developed psychotic side-effects of L-DOPA treatment (53% v
s. 9%) more often. A weak negative correlation between age and intelle
ctual quotient (IQ) was found, and a much stronger positive correlatio
n between education and IQ. 25 patients of those diagnosed previously
as nondemented were reassessed for dementia after another 5 years of d
isease. Only two of them were found demented. Both died and an immunoh
istochemical study of their brains was performed. In the 2 cases we fo
und neuropathological features of both PD (Lewy bodies) and Alzheimer'
s disease (AD)-neurofibrillary tangles (NFT) and senile plaques (SP).
This finding may support the hypothesis that, at least in some cases,
dementia in PD could be due to an accompanying AD.