Objective: To characterize the presence and clinical presentation of PD-MCI and PDD in patients with idiopathic PD, examining motor and non-motor features and determining factors associated with cognitive impairment.

Background: Cognitive impairment is one of the most frequent and disabling non-motor symptoms in Parkinson’s disease (PD) [1] and encompasses a continuum from mild cognitive impairment (PD-MCI) to dementia (PDD) [2]. The risk factors associated with them are not completely elucidated [3].

Method: A multi-center, cross-sectional study in 298 PD patients, that underwent clinical, neurological, neuropsychological and neuropsychiatric assessment. Movement Disorders Society (MDS) criteria [4,5] were applied for classifying the patients as normal cognition (NC), PD-MCI and PDD. The association between variables was explored using multivariate binary and multinomial logistic regression models.

Results: 72 (24.2%) patients were classified as NC, 82 (27.5%) as PD-MCI and 144 (48.3%) as PDD. PDD and PD-MCI groups reported more psychosocial problems related with the disease (mean SCOPA-PS 16.27 and 10.39, respectively), compared with NC (7.28) and lower quality of life outcomes (PDQ-8 48.98 and 28.42, respectively) compared to NC (19.05). The logistic regression analysis showed that both cognitive impaired groups had a more severe stage of PD measured by Hoehn and Yahr (odds ratio for MCI-PDD, OR 2.45, 95% confidence interval, CI 1.22-4.90, OR for PDD 2.64, 95%CI 1.17-5.98). Specifically, age (OR 1.30, 95%CI 1.16-1.47), disease duration (OR 1.19, 95%CI 1.07-1.32), SCOPA-PC (OR 1.12, 95%CI 1.02-1.24), HADS-D (OR 1.20, 95% CI 1.06-1.35), and hallucinations (OR 2.98, 95%CI 1.16-7.69) were related to PDD.

Conclusion: Cognitive impairment in PD is associated with more severe disease stage, resulting in a global, neuropsychiatric, psychosocial and quality of life deterioration. This study provides a better understanding of the great impact that cognitive impairment has within the natural history of PD and its relationship with the rest of motor and non-motor symptoms in the disease.

References: 1. Xu Y, Yang J, Shang H. Meta-analysis of risk factors for Parkinson’s disease dementia. Transl Neurodegener. 2016;5:11. 2. de Lau LML, Verbaan D, Marinus J, van Hilten JJ. Survival in Parkinson’s disease. Relation with motor and non-motor features. Parkinsonism Relat Disord. 2014;20(6):613-6 3. Zhu K, van Hilten JJ, Marinus J. Predictors of dementia in Parkinson’s disease; findings from a 5-year prospective study using the SCOPA-COG. Parkinsonism Relat Disord. 2014;20(9):980-5. 4. Litvan I, Goldman JG, Tröster AI, Schmand BA, Weintraub D, Petersen RC, et al. Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Mov Disord. 2012;27(3):349-56. 5. Dubois B, Burn D, Goetz C, Aarsland D, Brown RG, Broe GA, et al. Diagnostic procedures for Parkinson’s disease dementia: recommendations from the movement disorder society task force. Mov Disord. 2007;22(16):2314-24.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/cognitive-impairment-in-parkinsons-disease-a-cross-sectional-association-study/