Diagnosing mild cognitive impairment in Parkinson's disease: which tests perform best in the Italian population?

Area of Science:

• Neurology
• Neuropsychology
• Movement Disorders

Background:

• Mild cognitive impairment (MCI) is prevalent in Parkinson's disease (PD) and predicts dementia.
• Early diagnosis of PD-related MCI (PD-MCI) is crucial for disease course management.
• Movement Disorders Society (MDS) task force recently established diagnostic criteria for PD-MCI.

Purpose of the Study:

• To identify the optimal neuropsychological tests for diagnosing PD-MCI based on MDS criteria in Italian-speaking PD patients.
• To evaluate the diagnostic accuracy of a shortened 10-test battery compared to a comprehensive 23-test battery.
• To explore the utility of the 10-test battery for subtyping PD-MCI based on cognitive domain involvement.

Main Methods:

• A comprehensive 23-item neuropsychological battery was administered to PD patients.
• A subset of 10 tests, two per cognitive domain, was selected based on performance.
• Diagnostic accuracy and subtyping capabilities of the 10-test battery were compared to the full battery.

Main Results:

• The 10-test battery achieved 73% sensitivity and 100% specificity for PD-MCI diagnosis.
• For PD-MCI subtyping, the battery showed 69% sensitivity and 100% specificity.
• A modified 10-test battery for patients over 70 years demonstrated 84% sensitivity and 100% specificity for diagnosis.

Conclusions:

• A 10-test neuropsychological battery offers a practical balance between diagnostic accuracy and application time for PD-MCI.
• This shortened battery shows promise for efficient PD-MCI diagnosis and subtyping.
• Further prospective studies are recommended to validate the role of these batteries in clinical practice.