The influence of beta-amyloid and tau proteins on cognitive changes in Parkinson's disease

BACKGROUND: Parkinson's disease (PD) is the second most common neurodegenerative disorder after Alzheimer's dementia (AD), characterized by both motor and non-motor symptoms. Cognitive impairment is frequent and can progress to dementia. Early detection of cognitive dysfunction and timely intervention are crucial for maintaining quality of life. Identifying prognostic biomarkers for cognitive impairment therefore remains a key subject in PD research. OBJECTIVE: This literature review examines the prognostic value of AD-associated cerebrospinal fluid (CSF) biomarkers (beta-amyloid 1-42, beta-amyloid 1-40, total tau, and phosphorylated tau) in relation to cognitive impairment in patients with PD. METHODS: A systematic search was conducted in PubMed. Inclusion criteria required a formal diagnosis of PD, CSF analysis as well as cognitive testing. Studies without longitudinal data were excluded. RESULTS: 18 studies met the inclusion criteria, 11 of which utilized data from the Parkinson's Progression Markers Initiative (PPMI). Several studies demonstrated that lower CSF beta-amyloid 1-42 (Aβ42) levels and lower Aβ42:40 ratios were associated with faster cognitive decline. Findings for total tau and phosphorylated tau were inconsistent. CONCLUSION: Aβ and tau proteins show potential as biomarkers for cognitive decline in PD, but current evidence is insufficient to support their clinical use. Inconsistencies across studies, methodological variability and short follow-up periods limit their predictive value. Future research should include larger cohorts, standardized cognitive testing and extended follow-up periods to clarify their role.