Predict cognitive decline with clinical markers in Parkinson's disease (PRECODE-1)

Area of Science:

• Neurology
• Neuroscience
• Clinical Medicine

Background:

• Cognitive impairment affects approximately 80% of Parkinson's disease (PD) patients.
• Predictive factors for cognitive decline in early-stage, drug-naïve PD patients require further investigation.

Purpose of the Study:

• To identify clinically available markers that predict cognitive impairment in early drug-naïve Parkinson's disease patients.

Main Methods:

• 294 drug-naïve PD patients, cognitively normal at baseline, were recruited from the Parkinson's Progression Markers Initiative.
• Cognitive impairment was assessed at 36-month follow-up using Montreal Cognitive Assessment (MoCA) scores and neuropsychological tests.
• Predictive variables were analyzed based on validated cut-offs or deciles for maximal predictive power.

Main Results:

• 41.5% of patients (122/294) showed cognitive decline after 3 years.
• Predictors included age at PD onset, MDS-UPDRS Part-III, Hopkins Verbal Learning Test-Revised Recall, Semantic Fluency Test, and Symbol Digit Modalities Test.
• A combination of three abnormal tests predicted Level 1 and Level 2 cognitive impairment with 63.6-86.7% risk, respectively.

Conclusions:

• Clinically available measures can identify early-stage, drug-naïve PD patients at high risk for cognitive impairment.
• Implementing these markers can facilitate early monitoring and management of at-risk PD patients.