Objective: We aimed to identify if an impairment of the cube copy of the Montreal Cognitive assessment (MoCA) was associated with worse cognitive status in Parkinson´s disease (PD).

Background: Impaired copy of the interlocking pentagons of the Mini Mental State Exam (MMSE) has shown an increased risk for dementia in PD. The MoCA is a cognitive screening test which is more sensitive than the MMSE in Parkinson´s disease and its use is increasing.

Methods: Data of drug naïve Parkinson´s disease (PD) patients from the Parkinson´s Progression Markers Initiative were included in the study. Three hundred ninety-one patients had an intact cube copy (score of) whereas ninety-one failed it (score of 0). Patients with significant depression were excluded. Differences between demographic and clinical characteristics among the intact and impaired cube copy groups were analyzed using t-test and chi square test. In order to assess the association between the impairment of the copy cube and performance of neuropsychological variables, we performed a logistic regression analysis adjusted for educational level, age and PD duration.

Results: Patient groups with intact and impaired cube copy did not differ in disease duration or motor symptom severity. Patients with an impaired cube copy were older, had a lower educational level and had poorer performance on neuropsychological tests of attention (Letter Number Sequencing), phonemic and semantic verbal fluency, delayed memory recall (Hopkins Verbal Learning Test–Revised) and visuospatial skills (Judgment line orientation). A logistic regression analysis, which controlled for the impact of some demographic and disease-related variables, showed that an impaired cube copy was associated with a worse performance on all neuropsychological tests with the exception of phonemic verbal fluency.

Conclusions: Impaired cube copy on the MoCA in PD patients is associated with difficulties in widespread cognitive abilities, some of which reflect posterior cortical dysfunction. This is an easy and quick task that could determine which patients need a detailed neuropsychological assessment. Longitudinal studies are needed to demonstrate if this test also predicts dementia in PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/impaired-cube-copy-on-the-moca-indicates-worse-performance-in-several-cognitive-domains-in-parkinsons-disease/