Objective: Access the relation between subjective cognitive complaints (SCC) and objective cognitive impairment in Parkinson’s Disease (PD) patients with and without Dementia and evaluate the factors associated with SCC in cognitively normal PD patients

Background: SCC are frequent in the elderly population and there is some evidence that PD patients report SCC more frequently than healthy individuals. However, their role for identifying objective cognitive impairment is not clear. Simultaneously, an association between SCC, depression and anxiety has been described.

Methods: We assessed consecutive PD patients from our outpatient movement disorders clinic between March 2014 and March 2015. SCC were defined as present if the patient scored ≥1 in the Non-Motor Symptom assessment scale for Parkinson’s Disease (NMSS) domain 5. MoCA was used for objective cognitive assessment, and we used age and schooling adjusted cut-offs to define cognitive dysfunction. PD-Dementia (PDD) was defined by the presence of cognitive dysfunction with impact in daily activities ( Pill Questionnaire). PD-Mild Cognitive Impairment (PDMCI) was classified as cognitive dysfunction without impairment in daily living activities. The presence of Anxiety or Depression was defined by a score ≥7 in the Hospital Anxiety and Depression Scale. Significance was set at p<0.05.

Results: We included 128 patients. PDD was diagnosed in 21 (16.4%) patients, 95.2% reporting SCC. From 76 cognitively unimpaired (PDCN) patients, 82.9% reported SCC and from 31 PDMCI, 83.9% had SCC (p=0.361). 109 patients had SCC and severity was significantly different between PDD (20.0 ± 10.8) and PDCN (6.01 ± 6.87) or PDMCI (6.07 ± 5.975, p<0.001). Using a ROC analysis, a score of ≥19 in the NMSS-5 domain had a 91% specificity and 55% sensitivity for PDD identification. In PDCN, although SCC presence was associated with lower MoCA scores (24.15 ± 3.13 vs. 22.06 ± 3.48, p=0.049) the significance was lost (OR: 0.86, 95%CI: 0.70 – 1.06, p=0.148) when we adjusted the model to depression (OR: 5.72, CI95%: 1.14 – 28.7, p=0.034).

Conclusions: SCC are common in PD, and although their prevalence is not different between subgroups, their severity distinguishes PDD from non-demented PD patients. In PD-NC patients, SCC are probably a marker of depression (and not of objective cognitive impairment) and their presence should alert the clinician for an affective disorder.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/subjective-cognitive-complaints-in-parkinsons-disease-patients-what-should-we-value/