Objective: We investigated which clinical-ready and cost-effective markers are predictive of cognitive impairment (CI) in Parkinson’s disease (PD) in a cohort of 294 patients with early de novo PD from the Parkinson’s Progression Markers Initiative database.

Background: When James Parkinson first described the “shaking palsy” in 1871, he assumed that “the senses and intellect were uninjured.” Unfortunately, this claim was wrong. CI is currently considered one of the most common non-motor aspects of Parkinson’s disease PD, which greatly affects quality of life. Compared to the general population, having PD increased of six-fold the risk of developing dementia and approximately 80% of PD patients will develop dementia over the course of the disease. Several clinical risk factors of cognitive decline in PD have been identified including older age of onset, greater motor symptom burden, having an akinetic-rigid subtype and olfactory dysfunction. However, these predictors were not consistent across the studies.

Methods: Cognitive decline was defined as MoCA <26 at Level 1 diagnosis and as MoCA <26, in presence of clinical cognitive decline and at least 2 neuropsycholoigical test impaired at Level 2 diagnosis. The variables with a validated cut-off were divided into normal/abnormal, while the other variables were divided into deciles.

Results: At three years follow-up, 122/294 PD (41.5%) patients had a cognitive decline at Level 1, of which 53/122 (43.4%) received a confirmed diagnosis at Level 2. We found that age of onset, MDS-UPDRS Part-III, Hopkin’s Learning Verbal Test-Revised Recall, Semantic Fluency Test, Symbol Digit Modalities Test were all predictors of cognitive decline. We found that grouping patients by using these variables allow identifying 63.6–86.7% of subjects developing CI.

Conclusions: Our findings show that these clinical-ready and cost-effective measures have the ability to identify PD patients with the highest risk for CI and therefore, provide with an opportunity for early detection of potential candidates for novel neuroprotective treatments.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/predict-cognitive-decline-with-clinical-markers-in-parkinsons-disease/