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.
Original language | English (US) |
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Pages (from-to) | 107-114 |
Number of pages | 8 |
Journal | Parkinsonism and Related Disorders |
Volume | 33 |
DOIs | |
State | Published - Dec 1 2016 |
Keywords
- Cognition
- Mild cognitive impairment
- Parkinson's
- Patient-reported
ASJC Scopus subject areas
- Neurology
- Geriatrics and Gerontology
- Clinical Neurology