Objective: To describe Cognitive Impairment in the Kenyan PD TraPCAf cohort.

Background: The epidemiology and natural history, including cognitive impairment (CI) of Parkinson’s disease (PD) from sub-Saharan Africa (SSA), is scarcely described. The Transforming Parkinson’s Care in Africa (TraPCAf) multi-site Consortium in SSA aims to address this gap in the literature.

Method: Patients with PD were recruited prospectively at our clinical site from June 2025. CI was defined using MoCA scores: Normal (≥26), Mild (21-25), Moderate (11-20), Severe (≤10). Functional status was assessed using the IDEA screen (range 0-15; higher = better). Additional assessments included CISI-PD, MDS-UPDRS, Hoehn & Yahr (H&Y) staging, and a Neuroassessment for subjective cognitive decline. Data presented as mean ±SD for continuous and median (IQR) for ordinal variables. We used Spearman’s rank correlation (ρ) stratified by age (≤50, 51-65, >65 years) and gender, for statistical analysis.

Results: During recruitment calls, we noted that 19.8% (75/378) of our hospital PD-registered patients were already diagnosed with dementia and were therefore excluded from TraPCAf. For the study, we enrolled 95 PD patients: 62% (59/95) were male, age (mean±SD) 61.9±11.2 years, and were predominantly [87% (83/95)] urban dwellers. MoCA-defined CI affected 71% (67/95): 44% mild, 23% moderate, 4% severe. Mean MoCA was 22.6±4.8; median H&Y 2 (IQR 1–3); median IDEA 13 (IQR 11–15); median CISI-PD 1 (IQR 1–3). Young-onset (≤50y, n=22) had preserved cognition (MoCA 26.6±2.1, 73% H&Y 1) vs. elderly (>65y, n=34) with decline (MoCA 20.1±4.9, 30% H&Y 4–5). Motor-cognition correlation was absent in young-onset (ρ=-0.31, p=0.16) but strong in >50y (ρ=-0.52, p<0.001). Females outperformed males across all measures, with the widest gap in >65y (MoCA: 21.2 vs 19.4; MDS-UPDRS: 70.5 vs 80.1). 77% accurately reported subjective decline, with lower MoCA (21.8 vs 24.1, p=0.008), lower IDEA (12.3 vs 13.5, p=0.02), and higher MDS-UPDRS (68.9 vs 56.1, p=0.01). CISI-PD correlated strongly with all objective measures (MDS-UPDRS ρ=+0.72, H&Y ρ=+0.65, IDEA ρ=-0.54, MoCA ρ=-0.48; all p<0.001).

Conclusion: Our largely urban PD cohort had a high burden of CI, with preserved insight in the majority. Increased motor symptoms correlated with CI. The female resilience was an interesting finding that warrants further investigation.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognition-and-dementia-in-a-kenyan-parkinsons-disease-cohort-a-sub-study-of-the-trapcaf-consortium/