Risk of Parkinson's disease dementia related to level I MDS PD‐MCI

Abstract

Background The International Parkinson and Movement Disorders Society criteria for mild cognitive impairment in PD need validation. The objectives of this present study were to evaluate prognostic validity of level I (abbreviated) International Parkinson and Movement Disorders Society mild cognitive impairment in PD criteria for development of PD dementia and compared them with level II (comprehensive) criteria. Methods We analyzed data from 8 international studies (1045 patients) from our consortium that included baseline data on demographics, motor signs, depression, detailed neuropsychological testing, and longitudinal follow‐up for conversion to Parkinson's disease dementia. Survival analysis evaluated their contribution to the hazard of Parkinson's disease dementia. Results Level I mild cognitive impairment in PD, increasing age, male sex, and severity of PD motor signs independently increased the hazard of Parkinson's disease dementia. Level I and level II mild cognitive impairment in PD classification had similar discriminative ability with respect to the time to Parkinson's disease dementia. Conclusions Level I mild cognitive impairment in PD classification independently contributes to the hazard of Parkinson's disease dementia. This finding supports the prognostic validity of the abbreviated mild cognitive impairment in PD criteria. © 2019 International Parkinson and Movement Disorder Society

Neuropsychiatric symptoms are associated with dementia in Parkinson’s disease but not predictive of it

“…In this study however, motor impairment, as measured by the UPDRS III score, did not add any useful predictive value once age and cognitive ability were known. This finding is supported by two recent multinational studies which both found that when UPDRS III scores were accounted for, cognitive impairment independently increased PDD risk [4, 27] .…”

Clinical Characterization of Parkinson's Disease Patients With Cognitive Impairment

“…We found significant differences in sociodemographic, disease-related, and clinical variables depending on the severity of cognitive impairment, suggesting the usefulness of these criteria to classify PD-MCI and PDD patients according to their cognitive status. Recent studies reveal that levels I and II MCIs in PD classification have similar discriminative ability to predict the hazard of PDD ( 56 ). Nevertheless, previous studies suggest that level I criteria could be too broad and have a poor sensibility to classify PD patients; therefore, results should be interpreted carefully ( 57 – 59 ).…”

Parkinson’s Disease–Mild Cognitive Impairment (PD-MCI): A Useful Summary of Update Knowledge

“…This finding was then corroborated by other investigations (Stefanova et al, 2015; Bezdicek et al, 2017) while the utility of MDS Level I diagnostic criteria for MCI has been under debate for a long period (Szeto et al, 2015; Uysal-Cantürk et al, 2018). Lastly, the MDS Study group (Hoogland et al, 2019) concluded that Level I PD-MCI criteria classification also confers an independent contribution to the hazard of PDD while taking age, sex, education, motor sign severity, and depression into account, supporting its feasibility for neuropsychological diagnosis. With MDS Level II criteria, multiple domain impairment was more frequent than single-domain impairment, with predominant executive functioning, memory, and visuospatial deficits (Litvan et al, 2012; Cammisuli and Crowe, 2018).…”