Session Information
Date: Wednesday, June 22, 2016
Session Title: Parkinson's disease: Cognition
Session Time: 12:00pm-1:30pm
Location: Exhibit Hall located in Hall B, Level 2
Objective: 1. to describe the performance in Montreal Cognitive Assessment (MoCA) in a sample of Parkinson’s disease patients with normal Mini-Mental State Examination (MMSE). 2. to describe dependence on others for daily living activities in a sample of Parkinson’s disease patients with normal MMSE.
Background: The MMSE seems to be an insensitive test for screening of cognitive impairment in Parkinson’s disease. Even with normal performance on this test, a significant number of Parkinsonian may have cognitive alteration with impact on daily living activities.
Methods: We studied a sample of 43 Parkinsonians with normal performance on MMSE considering Brazilian education cut-offs. We evaluated Parkinson’s disease cognitive performance through the MoCA and functional performance through an adapted version of the Disability Assessment for Dementia Scale applied to family members. This adapted version considered dependence when Parkinsonian needed help more than fifty percent of the time on any daily living activities researched. Moreover, only dependence on others stemmed from cognitive impairment were considered.
Results: The sample included 65.1% of males, with mean age and education being 63.3 and 10,5 years, respectively. Mean disease duration was 11.1 years, mean UPDRS-part III score was 22.6, and most patients were Hoehn and Yahr stage II (58,1%). Mean MMSE score was 27.3 (SD:1.6) and mean MoCA score was 24.4 (SD:2.97) (table 1). Despite normal score on MMSE, considering a Brazilian education cut-offs, 74.4% of the sample performed lower than literature cut-off point of 26 on MoCA. Still, 30.2% showed dependence on others for daily living activities. When we considered just 37 patients with normal performance on MMSE considering the International Parkinson and Movement Disorder Society cut-off for dementia associated with Parkinson’s disease (26 points), 67,5% performed lower than cut-off point of 26 on MoCA. Also, 24,3% showed dependence on others for daily living activities.
Conclusions: Despite normal MMSE, a significant number of Parkinsonian performed below the cutoff point of 26 on Montreal Cognitive Assessment and showed dependence on others for daily living activities.
| Characteristics | Mean (standard deviation) | Frequency (absolute number) |
| Age, years | 63,6 (8,2) | – |
| Education, years | 10,5 (4,2) | – |
| Gender, male | – | 65,1% (28) |
| Disease duration, years | 11,1 (4,6) | – |
| UPDRS-part III, score | 22,6 (10,7) | – |
| Hoehn and Yahr stage I | – | 14% (6) |
| Hoehn and Yahr stage II | – | 58,1% (25) |
| Hoehn and Yahr stage III | – | 23,3% (10) |
| Hoehn and Yahr stage IV | – | 4,7% (2) |
| Tremor dominant subtype | – | 27,9% (12) |
| Postural stability and gait difficult dominant subtype | – | 72,1% (31) |
| Hallucination (Neuropsychiatric Inventory) | – | 16,3% (7) |
| Hospital Depression and Anxiety scale, depression score | 6 (2,9) | – |
| Hospital Depression and Anxiety scale, anxiety score | 6,8 (3,5) | – |
| Apathy Scale, score | 7,9 (6,9) | – |
| L-dopa equivalent dose | 979,5 (400,7) | – |
| Anticholinergic use | – | 18,6% (8) |
| Benzodiazepine use | – | 37,2% (16) |
| Antidepressant use | – | 32,6% (14) |
| Antipsychotic use | – | 14% (6) |
| Mini-mental State Examination, score | 27,3 (1,6) | – |
| Montreal Cognitive Assessment, score | 24,4 (2,97) | – |
To cite this abstract in AMA style:
R. Breder, M.A.A. Leite, B.L. Pessoa, C.O. Vilaça. Performance in Montreal cognitive assessment and functional independence in Parkinsonian with normal mini-mental state examination [abstract]. Mov Disord. 2016; 31 (suppl 2). https://www.mdsabstracts.org/abstract/performance-in-montreal-cognitive-assessment-and-functional-independence-in-parkinsonian-with-normal-mini-mental-state-examination/. Accessed June 14, 2025.« Back to 2016 International Congress
MDS Abstracts - https://www.mdsabstracts.org/abstract/performance-in-montreal-cognitive-assessment-and-functional-independence-in-parkinsonian-with-normal-mini-mental-state-examination/