Objective: To investigate the role of neuropsychologists, and their current practices for assessing cognition in Parkinson’s disease (PD).

Background: Diagnosis and evaluation of cognitive disorders in PD remains suboptimal despite its high prevalence. Variability in neuropsychology methods to assess cognitive dysfunction in PD may impact the accuracy of cognitive diagnoses across clinics.

Method: Information regarding current neuropsychology practices were collected via an online national survey and semi-structured interviews. Australian clinical neuropsychologists with experience administering cognitive assessments in PD patients were invited. Descriptive statistics and Fisher’s exact tests were used to analyse quantitative data. NVIVO software was used to analyse qualitative interview transcripts and free-text survey responses via coding reliability thematic analysis.

Results: Sixteen participants completed the online survey and five participants completed a qualitative interview. Most neuropsychologists (85%) reported PD patients to comprise a small portion of their caseload, with a quarter or less undergoing longitudinal tracking (70%). Patients were primarily referred to determine deep brain stimulation (DBS) candidacy (55%), or for cognitive disorder diagnostic queries (30%). Most neuropsychologists reported to not use published guidelines or other resources when planning assessments in PD (60%). Tests, and criteria used to determine impairment and cognitive diagnoses varied across all neuropsychologists. Common challenges for cognitive assessment in PD included motor symptom interference (60%), availability of appropriate tests (16%), and time constraints (16%). Fisher’s exact tests revealed neuropsychologists mainly referred for DBS candidacy reported issues with test availability and time constraints significantly more often than those mainly referred for diagnostic enquiry. Qualitative results provided further context behind the rationale and barriers to clinical decision-making for Australian neuropsychologists working with PD patients.

Conclusion: This study elucidated the procedural heterogeneity across Australian neuropsychologists when assessing cognition in PD. Future research to help standardise neuropsychological assessment for PD patients is required to ensure to best practices are used and diagnostic accuracy maximised.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-assessment-in-parkinsons-disease-a-mixed-methods-study-of-current-neuropsychology-practices-in-australia/