Objective: To describe the association between global cognition (MoCA) and balance (GDI) in patients with Parkinson disease.

Background: More than 62% of patients with Parkinson Disease (PD) experience falls, which has been associated with alterations in posture, gait and cognition (1). Postural control depends on the appropriate integration between sensory, cognitive and motor information. These domains are usually affected by PD, which would increase the risk of falls, affecting the quality of life in these patients. The executive cognitive dysfunction (2) affects the integration between the sensory and motor planning systems required to maintain the balance especially in dynamic tasks such as walking.

Methods: 30 individuals with PD diagnosis and 30 healthy subjects (age matched) were recruited for the study. Global cognition was evaluated using MoCA test. MDS-UPDRS part III, Dynamic Gait Index (DGI) and Freezing of Gait Questionnaire (FOGQ) were obtained. Mann Whitney and Chi-squared test were used for comparison between groups. Statistically significant difference was considered if the p-value was lower than 0.05.

Results: Median duration of the disease from onset was 5 years (IQR 1-7). Hoehn and Yahr stage classification was I (16.6%), II (73.3%) and III (10.0%). MDS-UPDRS mean was 39.06 (±13.74) [table 1]. Significant differences were found for TMT-B (p: 0.003), Repeat (p: 0.027), Fluency (p: 0.029), Gait surface level (p: 0.028), Gait with vertical head turns (p: 0.007) and Gait with horizontal head turns (p: <0.001) [Figure 1]. Significant associations between MoCA test and GDI were found for: Clock and Gait with pivot turn (p: 0.026), Gait over (p: 0.014) and around obstacles (p: 0.019). Naming and: Gait level surface (p: 0.004), Gait with horizontal head turns (p: 0.007), Gait with pivot turn (p: 0.006), over obstacles (p: 0.004) and GDI total score (p: 0.006). Serial subtraction and Gait with pivot turn (p: <0.001) [table 2].

Conclusions: Our results indicate that there is a close relationship between posture and global cognition especially in executive, visuospatial and language domains assuming an alteration of dopaminergic and non-dopaminergic circuits. Subsequent analyzes indicate that MoCA is useful in the assessment of global cognition in patients with PD; however, individual item performance could be affected by variables such as scholarship and age.

References: 1. Barbosa AF, Chen J, Freitag F, Valente D, Souza C de O, Voos MC, et al. Gait, posture and cognition in Parkinson’s disease. Dement Neuropsychol. 2016;10(4):280-6. 2. Hendershott TR, Zhu D, Llanes S, Poston KL. Domain-specific accuracy of the Montreal Cognitive Assessment subsections in Parkinson’s disease. Parkinsonism Relat Disord. 2017 May;38:31-4.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-function-is-associated-with-balance-in-parkinson-disease-cross-sectional-study-in-cali-colombia/