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Parkinsonism Relat Disord. 2016 Dec;33:107-114. doi: 10.1016/j.parkreldis.2016.09.025. Epub 2016 Sep 27.

Cognitive impairment in Parkinson's disease: Association between patient-reported and clinically measured outcomes.

Author information

1
Movement Disorders Division, Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, 21287, United States; Corresponding author. Johns Hopkins Dept. of Neurology, 600 N. Wolfe Street, Meyer 6-181D, Baltimore, MD, 21287, United States. Electronic address: kmills16@jhmi.edu.
2
Movement Disorders Division, Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, 21287, United States; Morris K. Udall Parkinson's Disease Research Center, Johns Hopkins University School of Medicine, 10751 Fall Road, Suite 250, Lutherville, MD 21093, Baltimore, MD, United States.
3
Morris K. Udall Parkinson's Disease Research Center, Johns Hopkins University School of Medicine, 10751 Fall Road, Suite 250, Lutherville, MD 21093, Baltimore, MD, United States.
4
Division of Medical Psychology, Dept. of Psychiatry and Behavioral Science, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 218, Baltimore, MD, 21287, United States.
5
Movement Disorders Division, Dept. of Neurology, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Meyer 6-181, Baltimore, MD, 21287, United States; Morris K. Udall Parkinson's Disease Research Center, Johns Hopkins University School of Medicine, 10751 Fall Road, Suite 250, Lutherville, MD 21093, Baltimore, MD, United States; Neuroregeneration and Stem Cell Programs, Institute for Cell Engineering, United States; Solomon H. Snyder Department of Neuroscience, United States; Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, 21205, United States.

Abstract

BACKGROUND:

In Parkinson's disease, the association between objective and patient-reported measures of cognitive dysfunction is unknown and highly relevant to research and clinical care.

OBJECTIVE:

To determine which cognitive domain-specific Montreal Cognitive Assessment (MoCA) subscores are most strongly associated with patient-reported cognitive impairment on question 1 (Q1) of the Movement Disorders Society Unified Parkinson's Disease Rating Scale (MDS-UPDRS).

METHODS:

We analyzed data from 759 PD participants and 481 persons without PD with in a retrospective, cross sectional analysis using data from the NINDS Parkinson's Disease Biomarkers Program (PDBP), a longitudinal, multicenter biomarker study. The relationship between a patient-reported cognitive rating (MDS-UPDRS q1.1) and objective cognitive assessments (MoCA) was assessed using multinomial logistic regression modeling and the outcomes reported as conditional odds ratios (cOR's) representing the relative odds of a participant reporting cognitive impairment that is "slight" versus "normal" on MDS-UPDRSq1.1 for a one unit increase in a MoCA sub-score, adjusted for age and education.

RESULTS:

In PD participants, changes in visuospatial-executive performance and memory had the most significant impact on subjective cognitive impairment. A 1-point increase in visuospatial-executive function decreased the chance of reporting a MDS-UPDRS Q1 score of "slight" versus "normal" by a factor of 0.686 (p < 0.001) and each 1 point improvement in delayed recall decreased the odds of reporting "slight" cognitive impairment by a factor of 0.836 (p < 0.001).

CONCLUSIONS:

Conversion from a PD patient's report of "normal" to "slight" cognitive impairment may be associated with changes in visuospatial-executive dysfunction and memory more than other cognitive domains.

KEYWORDS:

Cognition; Mild cognitive impairment; Parkinson's; Patient-reported

PMID:
27733275
PMCID:
PMC5154808
DOI:
10.1016/j.parkreldis.2016.09.025
[Indexed for MEDLINE]
Free PMC Article

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