Cognitive profiles and optimal cut‐offs for routine cognitive tests in elderly individuals with Parkinson's disease, Parkinson's disease dementia, Alzheimer's disease, and normal cognition

Abstract

Aim: The cognitive impairment seen in Parkinson's disease (PD) results in patient disability and reduced quality of life. However, using cognitive screening scales specific to PD in routine clinical practice is difficult because of limited time, resources, and skills. We studied the ability of routine cognitive tests to differentiate between Parkinson's disease dementia (PDD) and PD and among the neuropsychological profiles of elderly individuals with PD, PDD, Alzheimer's disease (AD), and normal cognition. Methods: This cross-sectional study involved 124 subjects. Subjects were 35 cognitively normal elderly and 37 elderly individuals with PD, 22 with PDD, and 30 with AD. All subjects were diagnosed by a specialist using standard criteria. Clinically relevant data and scores from the Montreal Cognitive Assessment and the Thai Mental State Examination were collected. Cognitive test scores were compared among groups. Receiver operating characteristic curves were constructed for a range of cut-off points to explore the sensitivity and specificity of the screening tools to detect PDD. Results: There were 74 female subjects (59.7%), and the average age of all subjects was 75.6 years. The median score on the modified Hoehn and Yahr scale was 2.5 in subjects with PD and 4 in those with PDD (P < 0.001). The cut-offs for differentiating PDD from PD were 25 on the Thai Mental State Examination and 14 on the Montreal Cognitive Assessment. The sensitivity of the Thai Mental State Examination was 78.4%, and the specificity was 66.7% (area under the curve: 0.828). The sensitivity of the Montreal Cognitive Assessment was 81.1%, and the specificity was 75% (area under the curve: 0.876). There was a significant difference in the memory and language subdomains between AD and PDD (P < 0.05). Conclusions:The cut-offs used to differentiate PDD from PD were not the same as routine cut-offs in distinguishing AD from normal elderly. The cognitive profile deficit in PDD differed from that in AD. Interpretations of positive screenings test should take this finding into consideration.

Adherence rate, barriers to attend, safety and overall experience of a physical exercise program via telemonitoring during COVID‐19 pandemic for individuals with Parkinson's disease: A feasibility study

“…The mean MoCA was 25.31 ± 4.78 and all scores was above 14, therefore no individuals with dementia (Phannarus et al., 2020 ). However, three participants scored below 21, indicating mild impairment for PD (Dalrymple‐Alford et al., 2010 ).…”

“…We invited individuals diagnosed with idiopathic PD who had been engaged in an in‐person community rehabilitation program at the School of Physical Education and Sport at USP, Brazil, to attend a telemonitoring‐based physical exercise program. The inclusion criteria were a) older than 18 years old; b) no orthopedic or cardiac diseases that prevent safe physical activity, or which are risk factors for other neurological diseases; c) Montreal Cognitive Assessment (MoCA) score higher than 14, indicating no dementia (Phannarus et al., 2020 ); and d) modified Hoehn & Yahr scale (H&Y) score between 1 and 3. As a standard procedure for the in‐person program that this group took part in before the COVID‐19 pandemic, participants had been evaluated by a physician between January and February 2020, and they were in health conditions for physical training.…”

Sequencing and Detection of Two Missense Variants at Chromosome 7 as Potential Azole Resistance Markers in Saccharomyces Cerevisiae

“…Although most studies used the consensus criteria for diagnosis of AD, VaD, and LBD [46], the exclusion criteria were not always uniform. Many authors excluded participants with psychotic disorders, history of substance abuse, and concurrent medication use [22,45,53], but not all authors confirmed the absence of vascular damage in participants with AD or LBD [39,47,49]. Therefore, some studies may have unknowingly included participants with mixed dementia instead of those with "pure" AD, VaD, or LBD.…”

“…Individuals with AD were found to perform significantly worse on the temporary memory binding (TMB) task compared to PDD and HC groups [38]. Relative to individuals with AD, older adults with PDD performed better on STM tasks, including the RMT [39], the Prose Memory test, and the STM Binding task [17]. One study demonstrated that both AD and PDD groups showed similar levels of impairment on explicit memory tasks, such as the Bushchke Selective Reminding Test, relative to HCs [18].…”

Adherence Rate, Barriers to Attend, Safety, and Overall Experience of a Remote Physical Exercise Program During the COVID-19 Pandemic for Individuals After Stroke

“…Individuals with a stroke diagnosis who attended the face-toface community rehabilitation program at the School of Physical Education and Sport, University of São Paulo, São Paulo, Brazil earlier were invited to join this study after the COVID-19 pandemic had started. The inclusion criteria were as follows: confirmed diagnosis of stroke by image or medical report; either types of stroke (ischemic and hemorrhagic) in chronic phase (Bernhardt et al, 2017); above 18 years old; no orthopedic, other neurological, and cardiac risk factors to exercise; and Montreal Cognitive Assessment (MoCA) score higher than 14 [no dementia (Phannarus et al, 2020); walking speed ≥0.4 m/s (home walker) (Fulk et al, 2017); and perform the face-to-face community rehabilitation program for at least 6 months]. The exclusion criteria were to show a cardiovascular or respiratory condition impairing performance training and/or health safety during exercise.…”