Cognitive profiling of Parkinson disease patients with mild cognitive impairment and dementia.
BACKGROUND
Prevalence of mild cognitive impairment (MCI) and dementia in Parkinson disease (PD) is variable because different classification criteria are applied and there is lack of consensus about neuropsychological tests and cut-off used for cognitive profiling. Given the important therapeutic consequences for patient management, we aimed at identifying suitable diagnostic cognitive tests and respective screening cut-off values for MCI and dementia in PD (PDD).


METHODS
We evaluated 105 PD patients using an extensive neuropsychological battery categorized as PD without cognitive impairment (PD-CNT) (35%), PD-MCI (47%) and PDD (18%) based on established criteria and calculated Receiver Operating Characteristic (ROC) curves.


RESULTS
We found different sensitivity and specificity among neuropsychological tests in detecting PD-MCI and PDD. In particular performance in attention/set shifting, verbal memory and language abilities, discriminated both PD-MCI and PDD from PD-CNT. Abilities involved mainly in semantic retrieval mechanisms discriminated PD-CNT from PD-MCI but also PD-MCI from PDD. Finally deficits in executive and visual-spatial abilities were only affected in PDD.


CONCLUSIONS
Our data point to an independent and different load of each test in defining different PD cognitive statuses. These findings can help selection of appropriate cognitive batteries in longitudinal studies and definition of stage-specific therapeutic targets.
"Fondazione Ospedale San Camillo" - I.R.C.C.S., Parkinson Unit, Venice, Italy. Electronic address: roberta.biundo@ospedalesancamillo.net.
Roberta
R
Biundo
"Fondazione Ospedale San Camillo" - I.R.C.C.S., Parkinson Unit, Venice, Italy.
Luca
L
Weis
"Fondazione Ospedale San Camillo" - I.R.C.C.S., Parkinson Unit, Venice, Italy.
Silvia
S
Facchini
"Fondazione Ospedale San Camillo" - I.R.C.C.S., Parkinson Unit, Venice, Italy.
Patrizia
P
Formento-Dojot
"Fondazione Ospedale San Camillo" - I.R.C.C.S., Parkinson Unit, Venice, Italy.
Annamaria
A
Vallelunga
"Fondazione Ospedale San Camillo" - I.R.C.C.S., Parkinson Unit, Venice, Italy.
Manuela
M
Pilleri
"Fondazione Ospedale San Camillo" - I.R.C.C.S., Parkinson Unit, Venice, Italy.
Angelo
A
Antonini
D000368:Aged; D060825:Cognitive Dysfunction / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D003704:Dementia / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D010300:Parkinson Disease / Q000150:complications* / Q000523:psychology; D012372:ROC Curve; D012680:Sensitivity and Specificity
Cognitive tests; Cut-off score; Dementia; Mild cognitive impairment; Neuropsychology; Parkinson disease