Predicting Cognitive Decline in Parkinson’s Disease with Mild Cognitive Impairment: A One-Year Observational Study

Abstract

We conducted an observational study to investigate clinical predictors of cognitive decline in patients with mild cognitive impairment (MCI), with a focus on patients with Parkinson’s disease (PD) and Alzheimer’s disease (AD). The study was performed with detailed neuropsychological testing, a portable device for gait analysis, and a comprehensive geriatric assessment for patients with MCI. Cognitive decline was defined as subjective cognitive impairment with an objective decline in the Mini-Mental State Examination (MMSE) ≥2 points at the one-year follow-up. Participants (n = 74) had a median age of 70 (interquartile range 60–79) years, and 45.9% of them were women. At the end of the study, 17.6% of the patients with MCI had a cognitive decline. Although no differences were observed between groups at the baseline cognitive study, patients with PD-MCI demonstrated more cognitive decline than patients with AD-MCI (28.6% vs. 7.7% p = 0.03). Patients with PD-MCI had more physical disabilities, including scores of instrumental activities of daily living (IADL), Tinetti balance, and gait scores, and some Timed Up and Go components. Initial Clinical Dementia Rating—Sum of Boxes score was a better predictor of future cognitive decline than MMSE in PD-MCI. For predicting the occurrence of cognitive decline in PD-MCI, the prediction accuracy increased from the reduced model (AUC = 0.822, p < 0.001 ) to the full model (a total of five independent variables, AUC = 0.974, p < 0.001 ). Given the potentially modifiable predictor, our findings also highlight the importance of identifying sleep quality and the ability to perform IADL.

Neuropsychiatric, cognitive and brain morphology characteristics of conversion from Mild Cognitive Impairment to Alzheimer’s Disease

“…Regarding the significant role of memory performance, this is in line with the results of Baerresen et al (2015). The use of this type of model, with predictive purposes, is more frequent in recent years and could be applied in individuals with non-amnestic MCI (San Lee et al 2018), MCI due to Parkinson’s disease (Chen et al 2020) or even multiple sclerosis (Eijlers et al 2018). Unfortunately, these studies do not systematically mention the reliability criteria of their models.…”

Establishing an individualized model of conversion from normal cognition to Alzheimer's disease after 4 years, based on cognitive, brain morphology and neuropsychiatric characteristics

“…(2015) 45 . The use of this type of model, with predictive purposes, is more frequent in recent years and could be applied in individuals with non‐amnestic MCI, 21 MCI due to Parkinson's disease 46 or even multiple sclerosis 47 . Unfortunately, these studies do not systematically mention the reliability criteria of their models.…”

Dementia and Physical Therapy

“…PD patients with cognitive impairment walked slower and had shorter step length and stride length than those without cognitive impairment [35,36]. In those studies that only analyzed a sample of patients with dementia or cognitive impairment without a control group [37,38], the values recorded are below normal gait pattern.…”