People with Parkinson's disease and normal MMSE score have a broad range of cognitive performance

Burdick, Daniel; Cholerton, Brenna; Watson, G. Stennis; Siderowf, Andrew; Trojanowski, John Q.; Weintraub, Daniel; Ritz, Beate; Rhodes, Shannon; Rausch, Renecca; Factor, Stewart A.; Wood-Siverio, Cathy; Quinn, Joseph F.; Chung, Kathryn A.; Srivatsal, Sindhu; Edwards, Karen L.; Montine, Thomas J.; Zabetian, Cyrus P.; Leverenz, James B.

doi:10.1002/mds.25924

Cited by 70 publications

(57 citation statements)

References 29 publications

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“…In contrast to other neurodegenerative conditions which primarily feature cognitive deficits (such as Alzheimer disease), the cognitive profile in PD is more heterogeneous, likely reflecting the more variable underlying neuropathology (Lin & Wu, 2015; Burdick et al, 2014). Among the cognitive impairments present in individuals with PD, executive dysfunction is of particular interest for two reasons.…”

Section: Introductionmentioning

confidence: 96%

Investigation of factors impacting mobility and gait in Parkinson disease

Christofoletti

McNeely

Campbell

et al. 2016

Human Movement Science

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Mobility and gait limitations are major issues for people with Parkinson disease (PD). Identification of factors that contribute to these impairments may inform treatment and intervention strategies. In this study we investigated factors that predict mobility and gait impairment in PD. Participants with mild to moderate PD and without dementia (n=114) were tested in one session ‘off’ medication. Mobility measures included the 6-Minute Walk test and Timed-Up-and-Go. Gait velocity was collected in four conditions: forward preferred speed, forward dual task, forward fast as possible and backward walking. The predictors analyzed were age, gender, disease severity, balance, balance confidence, fall history, self-reported physical activity, and executive function. Multiple regression models were used to assess the relationships between predictors and outcomes. The predictors, in different combinations for each outcome measure, explained 55.7% to 66.9% of variability for mobility and 39.5% to 52.8% for gait velocity. Balance was the most relevant factor (explaining up to 54.1% of variance in mobility and up to 45.6% in gait velocity). Balance confidence contributed to a lesser extent (2.0% to 8.2% of variance) in all models. Age explained a small percentage of variance in mobility and gait velocity (up to 2.9%). Executive function explained 3.0% of variance during forward walking only. The strong predictive relationships between balance deficits and mobility and gait impairment suggest targeting balance deficits may be particularly important for improving mobility and gait in people with PD, regardless of an individual’s age, disease severity, fall history, or other demographic features.

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Section: Introductionmentioning

confidence: 96%

Investigation of factors impacting mobility and gait in Parkinson disease

Christofoletti

McNeely

Campbell

et al. 2016

Human Movement Science

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“…Sixty-four percent of persons with PD deemed cognitively normal by the MMSE scored 1.0 SD below normal on at least 2 other cognitive measures. Furthermore, this study concluded that if the MMSE were to be the only test utilized to detect dementia in persons with PD, then as many as 55% of dementia cases would have gone undetected in this population [59]. Thus, considering the prevalence of cognitive impairment and its impact on quality of life in persons with PD, it is imperative that appropriate neuropsychological testing be utilized to aide in early detection of cognitive impairment, especially in cases of individuals with previously identified risk factors.…”

Section: Clinical Bottom Linementioning

confidence: 92%

“…However, recent literature suggests that this test is not accurately able to identify cognitive impairment in persons with PD [59]. In a study by Burdick et al [59], it was found that more than half of persons with PD who scored above normal on the MMSE, also scored below normal on the Montreal Cognitive Assessment. Sixty-seven percent of those with normal MMSE scored 1.5 standard deviations below normal in at least 1 other cognitive test.…”

Section: Clinical Bottom Linementioning

confidence: 99%

“…Currently, in persons with PD the MMSE is utilized as the primary measure for neuropsychological screening [50]. However, recent literature suggests that this test is not accurately able to identify cognitive impairment in persons with PD [59]. In a study by Burdick et al [59], it was found that more than half of persons with PD who scored above normal on the MMSE, also scored below normal on the Montreal Cognitive Assessment.…”

Section: Clinical Bottom Linementioning

confidence: 99%

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The Cardiovascular and Cerebrovascular Effects on Cognition in Persons with Parkinson’s Disease: A Systematic Review of the Literature

Carey¹,

Julian²,

Kristeller³

et al. 2015

APD

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Purpose: The purpose of this systematic review of the literature is to examine the cerebrovascular and cardiovascular effects on cognition in persons with Parkinson's disease. Relevance: Physical therapy treatment of persons with Parkinson's disease (PD) has traditionally focused on lessening the impact of disease severity by improving quality of life and functional capacity. Research has shown that quality of life in persons with PD is not only significantly affected by motor symptoms, but also by the presence of defined non-motor symptoms such as cerebrovascular perfusion, cardiovascular dysfunction, and cognitive impairment. This study seeks to determine a causative effect among these non-motor symptoms with the intention to better manage cognitive impairment in persons with PD. Methods: A literature search was conducted utilizing the following databases: Scopus, PubMed, and CINAHL. After evaluating and grading studies using the Downs and Black Checklist, a total of seven studies remained for the final review. Results: Five common domains of cognition emerged throughout the seven studies: executive function, attention, verbal memory and fluency, visual memory, and working memory. Considering the articles reviewed, a relationship between cerebrovascular and cardiovascular deficiency and cognitive impairment in persons with PD was established. Conclusions: Persons with PD and certain cerebrovascular and cardiovascular risk factors, including orthostatic hypotension and systemic hypertension, should be referred to appropriate professionals for comprehensive neuropsychological testing secondary to an increased risk for more severe cognitive deficit.

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“…In a multi-center, cross-sectional, observational study, Burdick et al performed neuropsychological testing in a sample of 788 PD patients with MMSE ≥ 26 and found that a remarkably wide range of cognitive impairments was present in PD patients with normal MMSE scores. Among them, 67% of the subjects had impairment on one or more of the other fifteen neuropsychological tests and 45% had impairment on two or more tests [28]. Another study revealed that the overall discriminant validity for detection of any cognitive disorder was similar for the MMSE and the MoCA, but the MMSE was inferior to the MoCA as a screening instrument for PD-MCI [29].…”

Section: Research Lei Chenmentioning

confidence: 99%

Cognitive Function in Early and Advanced Parkinson’s disease

Chen¹,

Wang²

2018

Neuropsychiatry

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Objective: To investigate the occurrence of mild cognitive impairment (MCI) in early and advanced Parkinson's disease (PD) and identify the risk factors for PD-MCI.Methods: A total of 138 PD patients were recruited between April 2015 and December 2017. We evaluated demographic and clinical data, including sex, age, age of onset, disease duration, Hoehn and Yahr stage, Unified Parkinson's Disease Rating Scale (UPDRS) part Ⅲ, 39-item Parkinson's Disease Questionnaire (PDQ-39), Epworth Sleepiness Scale (ESS), Beck Depression Inventory (BDI) and Mini-Mental State Examination (MMSE) scores. Participants were divided into early and advanced PD groups according to Hoehn and Yahr stage. Group comparisons were performed using Student's t-tests or chi-square tests. Binary logistic regression was conducted to identify risk factors for PD-MCI. Results:There was no significant difference in MMSE scores between the early and advanced groups. According to PD-MCI Level 1 criteria, 27 individuals (30.0%) in the early group and 16 individuals (33.3%) in the advanced group were classified as having PD-MCI. The proportion of PD-MCI was not significantly different between the two groups (chi-square = 0.162, p = 0.687). No demographic or clinical factors were significantly associated with the development of PD-MCI. Conclusions:Cognitive impairment is stable in PD patients with short disease duration when the MMSE is used as a global cognitive test. The occurrence of PD-MCI is high, even in newly diagnosed PD patients.

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People with Parkinson's disease and normal MMSE score have a broad range of cognitive performance

Cited by 70 publications

References 29 publications

Investigation of factors impacting mobility and gait in Parkinson disease

Investigation of factors impacting mobility and gait in Parkinson disease

The Cardiovascular and Cerebrovascular Effects on Cognition in Persons with Parkinson’s Disease: A Systematic Review of the Literature

Cognitive Function in Early and Advanced Parkinson’s disease

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