Objective: To clarify clinical features of patients with progressive mild cognitive impairment patients (MCI) in Parkinson’s disease (PD-MCI).

Background: Non-demented PD subjects have MCI and PD-MCI convert to PD dementia within several years. However, predictors for progressive PD-MCI are not fully understood.

Methods: We analyzed data of 70 patients with PD-MCI diagnosed by the Movement disorder society PD-MCI criteria Level I at baseline and completed 1 to 2 year follow-up. We　examined five cognitive domains by neuropsychological tests of level II criteria as well as other non-motor symptoms including depression, apathy, fatigue, sleep disorders and impulse control disorder.

Results: Of the 70 PD-MCI patients, 20 patients converted to PDD (progressive PD-MCI), 35 patients remained MCI (stable PD-MCI) and 15 patients reverted to normal cognitive level (reverted PD-MCI). In the progressive PD-MCI group, scores of the Boston naming test (25.5±3.7 vs 27.6±2.4, OR0.79, p=0.038), and total scores of the Auditory verbal learning test (30.3±9.2 vs 39.1±7.7, OR0.87, p=0.007) at baseline were significantly lower compared to the stable PD-MCI and reverted PD-MCI group. The frequencies of compulsive sexual behavior (31.2% vs 2.8%, OR15.4, 95%CI 2.2-349, p=0.017), pathological gambling (31.2% vs 5.5%, OR7.7, 95%CI 1.3-45.6, p=0.024), and orthostatic hypotension (56.0% vs 24.0%, OR4.0, 95%CI 1.15-13.8, p=0.029) were significantly higher in the progressive PD-MCI group compared to the stable PD-MCI and reverted PD-MCI group.

Conclusions: Our study showed that, in addition to decline of memory domains, having compulsive sexual behavior, pathological gambling and orthostatic hypotension may be risk factors for development of dementia in PD-MCI patients.

References: Litvan I et al. Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: Movement Disorder Society Task Force guidelines. Mov Disord 2012;27:349–356.

Dalrymple-Alford JC, MacAskill MR, Nakas CT, et al. The MoCA: well-suited screen for cognitive impairment in Parkinson disease. Neurology 2010;75:1717–1725.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/predictor-of-progressive-mild-cognitive-impairment-in-patients-with-parkinsons-disease/