title: A recommended scale for cognitive screening in clinical trials of Parkinson's disease.
abstract: Cognitive impairment is common in Parkinson's disease (PD). There is a critical need for a brief, standard cognitive screening measure for use in PD trials whose primary focus is not on cognition. The Parkinson Study Group (PSG) Cognitive/Psychiatric Working Group formed a Task Force to make recommendations for a cognitive scale that could screen for dementia and mild cognitive impairment in clinical trials of PD where cognition is not the primary outcome. This Task Force conducted a systematic literature search for cognitive assessments previously used in a PD population. Scales were then evaluated for their appropriateness to screen for cognitive deficits in clinical trials, including brief administration time (<15 minutes), assessment of the major cognitive domains, and potential to detect subtle cognitive impairment in PD. Five scales of global cognition met the predetermined screening criteria and were considered for review. Based on the Task Force's evaluation criteria the Montreal Cognitive Assessment (MoCA), appeared to be the most suitable measure. This Task Force recommends consideration of the MoCA as a minimum cognitive screening measure in clinical trials of PD where cognitive performance is not the primary outcome measure. The MoCA still requires further study of its diagnostic utility in PD populations but appears to be the most appropriate measure among the currently available brief cognitive assessments. Widespread adoption of a single instrument such as the MoCA in clinical trials can improve comparability between research studies on PD.
authors.affiliation: Department of Neurology, University of Michigan, Ann Arbor, Michigan 48109-5316, USA. klchou@med.umich.edu
authors.forename: Kelvin L
authors.initials: KL
authors.lastname: Chou
authors.forename: Melissa M
authors.initials: MM
authors.lastname: Amick
authors.forename: Jason
authors.initials: J
authors.lastname: Brandt
authors.forename: Richard
authors.initials: R
authors.lastname: Camicioli
authors.forename: Karen
authors.initials: K
authors.lastname: Frei
authors.forename: Darren
authors.initials: D
authors.lastname: Gitelman
authors.forename: Jennifer
authors.initials: J
authors.lastname: Goldman
authors.forename: John
authors.initials: J
authors.lastname: Growdon
authors.forename: Howard I
authors.initials: HI
authors.lastname: Hurtig
authors.forename: Bonnie
authors.initials: B
authors.lastname: Levin
authors.forename: Irene
authors.initials: I
authors.lastname: Litvan
authors.forename: Laura
authors.initials: L
authors.lastname: Marsh
authors.forename: Tanya
authors.initials: T
authors.lastname: Simuni
authors.forename: Alexander I
authors.initials: AI
authors.lastname: Tröster
authors.forename: Ergun Y
authors.initials: EY
authors.lastname: Uc
mesh_terms: D002986:Clinical Trials as Topic; D003071:Cognition; D003072:Cognition Disorders / Q000150:complications / Q000175:diagnosis* / Q000523:psychology; D006801:Humans; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000523:psychology; D011594:Psychometrics; D011795:Surveys and Questionnaires