Objective: This systematic review aimed to critically evaluate current recommendations for evaluation, diagnosis and post-diagnostic care of cognitive impairment in Parkinson’s disease (PD).

Background: Methods for the evaluation and diagnosis of cognitive impairment in PD vary across movement disorders clinics. Guidelines assist in addressing this heterogeneity and provide recommendations for clinicians diagnosing cognitive impairment in PD.

Method: Systematic searches were performed in five academic and four grey literature databases by two independent reviewers. Terms related to Parkinson’s disease, cognition, and guidelines/recommendations were used. Articles from 2003-2023 available in English were eligible. Importantly, eligible articles were required to report one or more relevant recommendations related to cognitive impairment in PD. All included articles underwent data extraction and quality assessment.

Results: Twenty-nine articles met inclusion criteria, 25 of which were academic articles and 4 of which were grey literature. Guideline quality ranged from moderate to high. Consensus or Delphi procedures were employed by seven articles and systematic literature methods were employed by 10 articles, with nine articles using both methods and two articles with undisclosed methodology. Recommendations for the neuropsychological evaluation, diagnosis, care, and treatment for cognitive impairment in PD were summarised across articles. However, critical gaps were exposed in terms of recommendations for cognitive measures, care considerations, and referral pathways specific to cognitive impairment in PD, among other limitations.

Conclusion: Key recommendations from clinical practice guidelines for the diagnosis and evaluation of cognitive impairment in PD were summarised and critically evaluated in the present review, encouraging future clinical practice guidelines to address current gaps and discrepancies.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/critically-evaluating-best-practice-guidelines-for-cognitive-impairment-in-parkinsons-disease-a-systematic-review-pdcognicare/