Objective: To examine the relationship between domains of cognition, using the Montreal Cognitive Assessment (MoCA), and domains of balance, using the Mini Balance Evaluation Systems Test (MiniBESTest), in people with Parkinson’s disease (PD).

Background: A known relationship exists between cognition and balance in PD. Although balance is routinely assessed by physical therapists, cognition is not, due to reasons such as time constraints and an incomplete knowledge of this relationship. The MoCA is a fast and reliable test of global cognition that assesses a range of cognitive functions and is a validated screen for mild cognitive impairment in people with PD. The MiniBESTest is a commonly used balance assessment consisting of several domains that is also validated in PD. Knowledge of deficits in specific cognitive domains and their relationship to domains of balance may help inform physical therapy examination and intervention in people with PD. However, this relationship has not been fully explored.

Method: This cross-sectional study used consecutive sampling to recruit people with PD. Motor function was assessed using the Unified Parkinson’s Disease Rating Scale (UPDRS) Part III. Balance was assessed using the MiniBESTest. Cognition was assessed using the MoCA. Spearman’s rho correlations were used to evaluate bivariate relationships and multiple regression was used to assess multivariable relationships.

Results: One hundred and eight subjects met inclusion criteria and were included in the study (83.3% (n=90) male, mean age 70 (SD=8.3), mean UPDRS Part III total score of 36.1 (SD=13.7)). MiniBESTest total score was significantly correlated with MoCA total score (rho=0.496, p<0.001) as well as the visuospatial/executive, language, and delayed recall MoCA subdomains. A multiple regression model including age, UPDRS Part III, and the above MoCA subdomains explained 42.3% of variance and was a significant predictor of MiniBESTest scores (p=0.008). Delayed recall contributed significantly to the model (β=.649, p=0.008) whereas visuospatial/executive and language did not.

Conclusion: Although traditionally considered an assessment of global cognition, this study suggests that the MoCA and its subdomains, specifically delayed recall, are related to balance control. Mindfulness of these relationships and individual deficits may influence choice of balance measures and interventions in the rehabilitation setting.

« Back to 2023 International Congress

MDS Abstracts - https://www.mdsabstracts.org/abstract/can-a-global-measure-of-cognition-be-used-to-inform-balance-interventions-in-parkinsons-disease/