Objective: To compare four different neuropsychological screening instruments (DemTect, Mattis Dementia Rating Scale (MDRS), Mini Mental State Examination (MMSE) and Parkinson Neuropsychometric Dementia Assessment (PANDA)) in the assessment of cognitive deficits in PD.

Background: Cognitive dysfunctions are frequent symptoms in PD and range from mild cognitive deficits to dementia. There are different neuropsychological screening instruments available. So far it is unclear which test is most suitable to capture cognitive deficits in PD patients.

Methods: Neuropsychological screening data of 54 PD patients (age = 65.65 ± 6.43 years, disease duration = 10.72 ± 5.63 years) were analysed retrospectively. Within one test session, four cognitive screening instruments (DemTect, MDRS, MMSE and PANDA) and one of three screening instruments to assess affective symptoms (Beck Depression Inventory II or V, German “Depressionsscreening” DESC-I) were administered to each patient. Cut-off scores for possible cognitive impairment and/or dementia were based on the normative data for each test. Correlation of age and total test scores was calculated with Pearson correlation for normally distributed data and with Spearman’s rho for variables that violated the assumption of normality. Since data were not normally distributed, Wilcoxon signed-rank test was applied to compare the different screening instruments.

Results: Age did not correlate significantly with any of the total test scores (p=.053 – .420). PANDA indicated cognitive impairment and dementia in 38.9%, DemTect in 33.3%, MDRS in 25.9% and MMSE in 1.9% of PD patients. Statistical comparisons of screening instruments revealed a significant difference in detection of cognitive impairment and dementia between PANDA and MDRS (p=.04), PANDA and MMSE (p<.01), MDRS and MMSE (p<.01) and DemTect and MMSE (p<.01). PANDA indicated dementia in 22.2%, MDRS in 9.3%, DemTect in 5.6% and MMSE in 0% of patients. Significant differences were observed for comparisons between PANDA and DemTect (p=.01), PANDA and MDRS (p=.02), PANDA and MMSE (p<.01) and MDRS and MMSE (p=.03).

Conclusions: Although the possibility of false positives exists, PANDA and DemTect seem to be much more sensitive to detect cognitive impairment in PD than MDRS and MMSE. PANDA seems to be superior to MDRS and DemTect to detect dementia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuropsychological-assessment-of-cognitive-dysfunction-in-parkinsons-disease-a-comparison-of-four-screening-instruments/