Objective: We aimed to develop harmonised recommendations for the diagnosis, evaluation and management of cognitive disorders in PD using a modified Delphi process.
Background: Differences in the approach to diagnose and manage cognitive impairment in Parkinson’s disease (PD) across clinics can lead to delayed diagnosis, treatment and care for people with PD and mild cognitive impairment or dementia.
Method: Evidence-based recommendations were proposed to an expert panel to gauge agreement using a two-round modified Delphi process conducted through online surveys using a 5-point Likert scale. Consensus was defined as a median score above 4 and inter-quartile range below 1. Written feedback was also sought to guide revisions. In total, 29 Australian clinicians and researchers with multidisciplinary expertise in PD participated on the panel. Revisions to recommendations were made by a steering committee of 13 clinicians, researchers and lived experience experts, based on written feedback from respondents.
Results: Preparatory research identified 57 recommendations in the literature for the diagnosis, evaluation and management of cognitive disorders in PD. Seven recommendations in round 1 and one recommendation in round 2 were revised or removed due to low agreement and/or consensus. This resulted in a total of 51 consensus recommendations endorsed by the Delphi panel. Recommendations were made regarding who should receive a cognitive evaluation in clinical settings, as well as the diagnostic criteria, methods of neuropsychological evaluation, treatment and care for cognitive disorders in PD.
Conclusion: This study identified evidence-backed and expert-endorsed recommendations to harmonise and guide clinical practice for cognitive disorders in PD. Application of these recommendations is recommended in the context of tailored, person-centred care. As cognitive research in PD progresses, updates to these recommendations are encouraged to maintain their currency.
To cite this abstract in AMA style:
D. Pourzinal, D. Brooks, D. Sriram, L. Mitchell, N. Pachana, K. Shrubsole, B. Wood, J. O'Sullivan, R. Marsh, A. Lehn, J. Liddle, E. Tan, WK. Halford, N. Page, N. Dissanayaka. Modified Delphi consensus approach to develop recommendations for diagnosis, evaluation and management of cognitive disorders in Parkinson’s disease [abstract]. Mov Disord. 2025; 40 (suppl 1). https://www.mdsabstracts.org/abstract/modified-delphi-consensus-approach-to-develop-recommendations-for-diagnosis-evaluation-and-management-of-cognitive-disorders-in-parkinsons-disease/. Accessed October 5, 2025.« Back to 2025 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/modified-delphi-consensus-approach-to-develop-recommendations-for-diagnosis-evaluation-and-management-of-cognitive-disorders-in-parkinsons-disease/