Journal
JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY
Volume 88, Issue 8, Pages 648-652Publisher
BMJ PUBLISHING GROUP
DOI: 10.1136/jnnp-2016-315099
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Funding
- Parkinson's UK [J-0802]
- Lockhart Parkinson's Disease Research Fund
- National Institute for Health Research (NIHR) Newcastle Biomedical Research Unit based at Newcastle upon Tyne Hospitals NHS Foundation Trust
- Newcastle University
- NIHR Biomedical Research Centre
- MRC [MC_U105597119, MC_UU_00005/12] Funding Source: UKRI
- Medical Research Council [MC_U105597119, MC_UU_00005/12] Funding Source: researchfish
- National Institute for Health Research [NF-SI-0616-10011] Funding Source: researchfish
- Parkinson's UK [J-0802, G-1301] Funding Source: researchfish
- Wellcome Trust [103838/Z/14/Z] Funding Source: researchfish
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Background Mild cognitive impairment (MCI) is common in early Parkinson's disease (PD). We evaluated the stability of PD-MCI over time to determine its clinical utility as a marker of disease. Methods 212 newly diagnosed participants with PD were recruited into a longitudinal study and reassessed after 18 and 36 months. Participants completed a range of clinical and neuropsychological assessments. PD-MCI was classified using Movement Disorders Society Task Force level I (Montreal Cognitive Assessment <26) and level II (using cut-offs of 1, 1.5 and 2SD) criteria. Results After 36 months, 75% of participants returned; 8% of patients had developed a dementia all of which were previously PD-MCI. Applying level I criteria, 70% were cognitively stable, 19% cognitively declined and 11% improved over 36 months. Applying level II criteria (1, 1.5 and 2SD), 25% were cognitively stable, 41% cognitively declined, 15% improved and 19% fluctuated over 36 months. 18% of participants reverted to normal cognition from PD-MCI. Discussion Cognitive impairment in PD is complex, with some individuals' function fluctuating over time and some reverting to normal cognition. PD-MCI level I criteria may have greater clinical convenience, but more comprehensive level II criteria with 2SD cut-offs may offer greater diagnostic certainty.
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