Objective: To evaluate the relationship among individual items from the MDS-UPDRS Part I and measures of cognitive functioning in patients with PD.

Background: Non-motor symptoms and cognitive dysfunction are common in patients with PD. However, there are few studies assessing the relationship between non-motor aspects of experiences of daily living and cognitive functioning in these patients.

Methods: This retrospective study examined the relationship of individual items from the MDS-UPDRS (Part I) and five cognitive domains: 1) Attention/Working Memory (Digit Span Forward, Symbol Digit Modalities Test); 2) Executive functioning (Digit Span Backward, Frontal Assessment Battery, Animal fluency); 3) Recent memory (Word List Memory – Immediate, Delay, Recognition); 4) Language (Boston Naming Test-15 item, Similarities); and 5) Visuospatial (Judgment of Line Orientation-15 item, MMSE Pentagons). Raw scores for individual cognitive tests were transformed to z-scores based upon normative data from healthy controls examined at our center. The five cognitive domain scores were calculated by averaging z-scores for neuropsychological tests within each specific domain. Individual items from the MDS-UPDRS Part I were entered into a stepwise linear regression analysis to assess the contribution of items to domain scores.

Results: 167 patients with PD were assessed with the MDS-UPDRS Part I and cognitive testing. The mean age was 79.6 ± 15.1, with 15.4 ± 3.0 years of education, and disease duration of 29.4 ± 8.4 months. Regression analyses demonstrated that the Cognitive Impairment (CI), Hallucinations and Psychosis (HP), and Light Headedness on Standing (LHS) items best predicted scores on the Attention/Working Memory domain (F=4.84, df = 1,153, p=.029). The CI, HP, LHS, Apathy, and Anxiety items all predicted scores on the Executive domain (F=4.17, df=1,158, p=.043). The CI item best predicted scores on the Memory domain (F=24.12, df=1,163, p=.001), as well as the Visuospatial domain (F=6.41, df=1,154, p=.012). The Apathy item best predicted scores on the Language domain (F=25.83, df=1,162, p=.001).

Conclusions: Non-motor symptoms from the MDS-UPDRS have a strong relationship with cognitive domains. The CI item was related to four of the five domains, and HP, LHS, and Apathy items were related to two of the five domains. These findings support the use of the MDS-UPDRS as an outcome measure in studies of PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/relationship-of-mds-updrs-non-motor-symptoms-to-cognitive-functioning-in-patients-with-parkinsons-disease/