Application of the Chinese Version of the Montreal Cognitive Assessment-Basic for Assessing Mild Cognitive Impairment in Parkinson's Disease.

Qian Xu,Mengxi Zhou,Jianren Liu,Chunyan Jiang,Lei Zhao,Qing He,Wei Chen,Li Wu,Yourong Dong

doi:10.3390/brainsci11121575

Abstract

Mild cognitive impairment (MCI) is a common and pivotal non-motor symptom in Parkinson’s disease (PD). It is necessary to use the appropriate tools to characterize the cognitive profiles and identify the subjects at risk of MCI in clinical practice. A cohort of 207 non-demented patients with PD and 52 age- and gender-matched cognitively normal controls (NCs) underwent the Chinese Version of Montreal Cognitive Assessment-Basic (MoCA-BC) evaluation. Patients with PD also received detailed motor and non-motor evaluation by serial scales. Cognitive profiles were investigated in patients with PD-MCI, relative to patients with normal cognition (PD-NC) and cognitively NCs. In addition, differences in demography, major motor and non-motor symptoms were compared between patients with PD-MCI and PD-NC. There were 70 patients with PD-MCI, occupying 33.8% of the total patients. Patients with PD-MCI had impairment in multiple cognitive domains, especially in executive function, memory and visuospatial function on MoCA-BC, relative to cognitively NCs or PD-NC. Compared with PD-NC patients, PD-MCI patients were older (p = 0.002) and had a later onset age (p = 0.007) and higher score of the Unified Parkinson’s Disease Rating Scale (UPDRS) part III (p = 0.001). The positive rate of clinical possible rapid eye movement sleep behavior disorder (cpRBD) in the PD-MCI group was significantly increased relative to the PD-NC group (p = 0.003). Multivariate logistic analysis showed that older age (OR = 1.06; p = 0.012), higher score of UPDRS-III (OR = 1.03; p = 0.018) and the presence of cpRBD (OR = 2.10; p = 0.037) were independently associated factors of MCI in patients with PD. In conclusion, executive function, memory and visuospatial function are the main impaired cognitive profiles in PD-MCI via MoCA-BC. Aging, motor severity and RBD may be independently related factors of MCI in PD.

Highlights

As a common non-motor symptom in Parkinson’s disease (PD), cognitive impairment contributes to impaired health-related quality of life to the patients and increased economic burden to society [1,2]
Our results demonstrated that PD patients with mild cognitive impairment (MCI) had impairments in multiple cognitive domains except for orientation; old age, severe motor symptoms and positive cpRBD were associated with MCI in PD patients
We found that 33.8% of PD patients had MCI, which was consistent with previous reports with the MCI prevalence ranging from 18.9% to 38.2% [3]

Summary

Introduction

As a common non-motor symptom in Parkinson’s disease (PD), cognitive impairment contributes to impaired health-related quality of life to the patients and increased economic burden to society [1,2]. Mild cognitive impairment (MCI) in PD is a primary indicator of the transition between normal cognition and PD dementia (PDD). It is common in non-demented PD patients with a prevalence rate ranging from 18.9% to 38.2% [3]. Increasing age, late-onset disease, lower education level and more severe motor symptoms have been associated with PD-MCI [3,4]. Because of the important clinical implications of PD-MCI, it is necessary to use appropriate tools to assess MCI and identify the subjects at risk of PD-MCI in clinical practice

Methods

Results

Conclusion