Predictors of Cognitive Change in Parkinson Disease: A 2-year Follow-up Study

Carmen Gasca-Salas, HM CINAC (Centro Integral de Neurociencias Abarca Campal), Hospital Universitario HM Puerta del Sur, HM Hospitales.
Sarah Duff-Canning, The Edmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, University of Toronto.
Eric McArthur, London Health Sciences Centre, London, ON, Canada.
Melissa J. Armstrong, Department of Neurology, University of Florida College of Medicine; Gainesville, FL.
Susan Fox, The Edmond J Safra Program in Parkinson's Disease and the Morton and Gloria Shulman Movement Disorders Centre, Toronto Western Hospital, University of Toronto.
Christopher A. Meaney, Department of Family and Community Medicine, University of Toronto.
David F. Tang-Wai, Department of Medicine (Neurology), University of Toronto, University Health Network Memory Clinic.
David Gill, Rochester Regional HealthFollow
Paul J. Eslinger, Department of Neurology, Penn State Hershey Medical Center, Hershey, PA.
Cindy Zadikoff, Department of Neurology, Northwestern University.
Fred J. Marshall, Department of Neurology, University of Rochester, Rochester, NY.
Mark Mapstone, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
Kelvin L. Chou, Departments of Neurology and Neurosurgery.
Carol Persad, Psychiatry, Michigan Medicine, University of Michigan, Ann Arbor, MI.
Irene Litvan, Department of Neurosciences, Parkinson and Other Movement Disorders Center UC San Diego, La Jolla, CA.
Benjamin T. Mast, Psychological & Brain Sciences, University of Louisville, Louisville, KY.
Adam T. Gerstenecker, Department of Neurology, Division of Neuropsychology, University of Alabama at Birmingham, Birmingham, AL.
Sandra Weintraub, Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL.
Connie Marras, The Edmond J Safra Program in Parkinson's disease, University Health Network, University of Toronto, Toronto.

Department

Neurology

Document Type

Article

Publication Title

Alzheimer Disease and Associated Disorders

Abstract

BACKGROUND: Mild cognitive impairment is common in Parkinson disease (PD-MCI). However, instability in this clinical diagnosis and variability in rates of progression to dementia raises questions regarding its utility for longitudinal tracking and prediction of cognitive change in PD. We examined baseline neuropsychological test and cognitive diagnosis predictors of cognitive change in PD.

METHODS: Persons with PD, without dementia PD (N=138) underwent comprehensive neuropsychological assessment at baseline and were followed up to 2 years. Level II Movement Disorder Society criteria for PD-MCI and PD dementia (PDD) were applied annually. Composite global and domain cognitive z -scores were calculated based on a 10-test neuropsychological battery.

RESULTS: Baseline diagnosis of PD-MCI was not associated with a change in global cognitive z -scores. Lower baseline attention and higher executive domain z -scores were associated with greater global cognitive z -score worsening regardless of cognitive diagnosis. Worse baseline domain z -scores in the attention and language domains were associated with progression to MCI or PDD, whereas higher baseline scores in all cognitive domains except executive function were associated with clinical and psychometric reversion to "normal" cognition.

CONCLUSIONS: Lower scores on cognitive tests of attention were predictive of worse global cognition over 2 years of follow-up in PD, and lower baseline attention and language scores were associated with progression to MCI or PDD. However, PD-MCI diagnosis per se was not predictive of cognitive decline over 2 years. The association between higher executive domain z -scores and greater global cognitive worsening is probably a spurious result.

First Page

335

Last Page

342

DOI

10.1097/WAD.0000000000000576

Volume

37

Issue

4

Publication Date

10-1-2023

Medical Subject Headings

Humans; Follow-Up Studies; Parkinson Disease (complications, diagnosis); Cognitive Dysfunction (diagnosis, complications); Cognition; Neuropsychological Tests; Dementia (diagnosis)

PubMed ID

37615480

Link to Full Text

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