Objective: We aimed to design a neuropsychological test battery to diagnose Mild Cognitive Impairment (MCI) and to estimate the prevalence of MCI in Malayalam-speaking patients with Parkinson’s disease (PD) from South India.

Background: MCI is common in PD and a risk factor for PD-Dementia. Guidelines for diagnosis of PD-MCI have been published. [1] However, a comprehensive test battery as per published guidelines is currently unavailable for use in South Indian population speaking Malayalam, numbering around 40 million.  There is also little data on the prevalence of MCI among Indian PD patients.

Method: We designed a test battery comprising of two neuropsychological tests in Malayalam in each of the five cognitive domains, namely attention and working memory, executive functions, language, memory and visuospatial functions. Normative data from 50 healthy volunteers was used to decide cut-off scores for defining PD-MCI. The test battery was applied to 170 consecutive non-demented patients with PD to estimate the prevalence and characteristics of PD-MCI.

Results: Healthy volunteers and patients did not differ significantly with regard to age or level of education. 50 (29.4%) of the patients were found to have PD-MCI. Among the patients with PD-MCI, multi-domain involvement was seen in 43 and the rest had involvement of only one domain. Executive function, followed by memory were the most common domains affected. Patients with MCI were older (57.8 ± 8.3 years Vs 54.9 ± 8.6 years; p= 0.04), had longer duration of motor symptoms (9.3 ± 2.7 years Vs 5.0± 3.0 years; p <0.01) and lower MoCA scores (23.8 ± 2.8 Vs 26.6 ± 2.1; p <0.01) compared to those without.

Conclusion: We designed a neuropsychological test battery to diagnose PD-MCI in Malayalam speaking South Indian population. The prevalence of PD-MCI estimated with the battery is comparable to that reported from other populations. Multi-domain involvement was seen in the majority with MCI. Patients with PD-MCI   performed poorer on the Malayalam version of MoCA, one among the most widely used cognitive screening tests for PD.

References: 1. Litvan I, Goldman JG, Tröster AI, et al. Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Mov Disord 2012; 27:349-356.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/mild-cognitive-impairment-in-parkinsons-disease-in-south-indian-population-development-of-a-test-battery-and-assessment-of-prevalence-and-characteristics/