To compare quality of life, level of disability, and caregiver burden in 3 groups of people with Parkinson disease (PD): those with mild cognitive impairment (PD-MCI), those with dementia (PDD), and those with no cognitive impairment (PD-NC). Although the cognitive profile of those with PD-MCI and PDD has been well described, little is known about the personal and clinical impact of cognitive impairment and its impact on caregivers. Quality of life and disability were measured in 3 groups of participants with PD (PD-NC, n = 54; PD-MCI, n = 48; and PDD, n = 25). The PD-MCI group was classified using Movement Disorder Society Task Force consensus criteria. Caregivers (n = 102) in the 3 groups were assessed using the Zarit Burden Inventory. Both quality of life and caregiver burden were similar in the 2 groups without dementia but were significantly different in those with PDD. In contrast, global disability was progressively greater as cognition declined across the 3 PD groups: PD-NC < PD-MCI < PDD and on the Activities of Daily Living scale a step up in impairment was seen with the presence of any cognitive impairment. The presence of dementia significantly increases caregiver burden and decreases quality of life. However, even mild levels of cognitive impairment increase disability and overall functional impairment progresses in tandem with cognitive decline.

The COVID-19 global pandemic and subsequent public health social measures have challenged our social and economic life, with increasing concerns around potentially rising levels of social isolation and loneliness. This paper is based on cross-sectional online survey data (available in 10 languages, from 2 June to 16 November 2020) with 20,398 respondents from 101 different countries. It aims to help increase our understanding of the global risk factors that are associated with social isolation and loneliness, irrespective of culture or country, to support evidence-based policy, services and public health interventions. We found the prevalence of severe loneliness was 21% during COVID-19 with 6% retrospectively reporting severe loneliness prior to the pandemic. A fifth were defined as isolated based on their usual connections, with 13% reporting a substantial increase in isolation during COVID-19. Personal finances and mental health were overarching and consistently cross-cutting predictors of loneliness and social isolation, both before and during the pandemic. With the likelihood of future waves of COVID-19 and related restrictions, it must be a public health priority to address the root causes of loneliness and social isolation and, in particular, address the needs of specific groups such as carers or those living alone.

Degenerative diseases of the basal ganglia, such as Huntington's disease (HD), Parkinson's disease, and Wilson's disease, are characterized by motor, cognitive, and psychiatric manifestations. HD, in particular, can be considered a paradigmatic neuropsychiatric disorder that has all three components of the "Triadic Syndromes": dyskinesia, dementia, and depression. The authors examine the phenomenology, prevalence, and management of psychiatric disturbances occurring in diseases of the basal ganglia. They address psychiatric conditions such as depression, mania, psychosis, obsessive-compulsive disorders, aggression, irritability, apathy, sexual disorders, and delirium, discussing subtleties of diagnosis, and making reference to more unusual disorders of the basal ganglia, such as postencephalitic parkinsonism and Fahr's disease.