Objective: To identify modifiable vascular risk factors (VRFs) associated with cognitive decline in early PD.

Background: The importance of the early identification of modifiable risk factors associated with Mild Cognitive Impairment in Parkinson’s Disease is growing.

Method: PD patients of the PaCoS cohort who underwent a baseline and follow-up neuropsychological evaluations were enrolled in the study. PD-MCI and PDD were diagnosed according to the MDS criteria. Baseline brain MRI was used to calculate the white matter lesions (WMLs) burden using a visual scale. Laboratory data, presence of hypertension, diabetes and use of anti-hypertensive drugs were collected and the Framingham cardiovascular disease Risk Score (FRS) was calculated. VRFs predicting MCI and PDD were evaluated using Cox proportional hazard regression model.

Results: Out of 139 enrolled PD patients, 84 were classified as normal cognition (NC), 55 (39.6%) as MCI at baseline. At follow-up 28 (33.3%) PD-NC developed MCI and 4 (4.8%) PDD. Out of 55 PD-MCI patients at baseline, 14 (25.4%) converted to PDD at follow-up. Among PD-NC the presence of a higher systolic blood pressure (>135 mmHg) and use of anti-hypertensive were the stronger predictors of MCI at follow-up (adjHR 5.12; 95%CI 1.48-17.76; p-value 0.01 and adjHR 7.13; 95%CI 2.11-24.13: p-value 0.002 respectively). For PDD the risk was associated with MCI at baseline (adj HR 11.4; 95%CI 2.39-54.64; p-value 0.002), and a higher WML burden (adj HR 4.50 1.20-16.8 p-value 0.02).

Conclusion: In our sample the presence of hypertension at baseline represented the most important modifiable risk factors increasing of about 6 times the risk of MCI.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/vascular-risk-factors-wmls-and-the-risk-of-cognitive-impairment-in-parkinson-disease-a-longitudinal-study-from-the-parkinsons-disease-cognitive-impairment-study-pacos-cohort/