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Mild cognitive impairment in Parkinson's disease: the Parkinson's disease cognitive study (PACOS)
Roberto Monastero1, Calogero Edoardo Cicero2, Roberta Baschi3
1Department of Experimental Biomedicine and Clinical Neurosciences, Section of Neurology, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy. roberto.monastero@unipa.it.
Abstract:
Approximately 30% of Parkinson's disease (PD) patients show impaired cognitive performance, which is suggestive of Mild Cognitive Impairment (MCI), representing a predictor of dementia, especially when present at diagnosis. The objective of the study was to evaluate the frequency and clinical predictors of MCI in a large hospital-based cohort of PD patients. We collected cross-sectional data from the Parkinson's disease cognitive impairment study (PACOS), a multicenter study involving two Movement Disorder centers, which are located in south Italy. The PD subjects were diagnosed according to the UK Brain Bank criteria and they underwent an extensive neuropsychological assessment. PD-MCI was diagnosed according to the Movement Disorder Society task force criteria for MCI. PD severity was evaluated in accordance with the Unified PD Rating Scale-Motor Examination (UPDRS-ME) and the Hoehn and Yahr scales. The study included 659 PD patients (57.5% men; mean age 67.0 ± 9.7 years), with a mean disease duration of 3.8 ± 4.6 years and a mean UPRDS-ME score of 25.8 ± 12.3. PD-MCI was diagnosed in 261 (39.6%) subjects and in 82 (31.7%) of 259 newly diagnosed patients (disease duration ≤ 1 year). An amnestic MCI multidomain phenotype was the most frequent MCI subtype (39.1% of the overall sample and 43.9% in newly diagnosed PD). A positive significant association between MCI, age and motor scores was found at multivariate logistic regression analysis, while a negative association was observed between educational level and MCI. In conclusion and in agreement with the literature data, the prevalence of MCI recorded in the PACOS sample was approximately 40 and 32% amongst newly diagnosed patients.
Insights
Mild Cognitive Impairment (MCI) affects nearly 40% of Parkinson's disease (PD) patients, particularly older individuals with higher motor scores. Higher education levels may be protective against PD-MCI.
Area of Science:
- Neurology
- Neuroscience
- Cognitive Science
Background:
- Mild Cognitive Impairment (MCI) is prevalent in Parkinson's disease (PD), often predicting dementia.
- Understanding MCI frequency and predictors in PD is crucial for early intervention.
Purpose of the Study:
- To determine the prevalence of MCI in a large hospital-based PD cohort.
- To identify clinical predictors associated with MCI in PD patients.
Main Methods:
- Cross-sectional study of 659 PD patients from two Movement Disorder centers in Southern Italy (PACOS study).
- Diagnosis of PD based on UK Brain Bank criteria.
- Neuropsychological assessment for MCI diagnosis using Movement Disorder Society criteria.
- Evaluation of PD severity using UPDRS-Motor Examination and Hoehn and Yahr scales.
Main Results:
- MCI was diagnosed in 39.6% of the overall PD sample and 31.7% of newly diagnosed patients.
- The amnestic MCI multidomain phenotype was the most common subtype.
- Multivariate analysis revealed significant positive associations between MCI and age/motor scores, and a negative association with educational level.
Conclusions:
- The prevalence of MCI in the studied PD cohort is substantial, aligning with existing literature.
- Age and motor symptom severity are associated with increased risk of MCI in PD.
- Higher educational attainment may offer a protective effect against developing MCI in Parkinson's disease.