Abstract
BackgroundIdentifying predictors of incident cognitive impairment (CI), one of the most problematic long‐term outcomes, in Parkinson's disease (PD) is highly relevant for personalized medicine and prognostic counseling. The Nonmotor Symptoms Scale (NMSS) provides a global clinical assessment of a range of NMS, reflecting NMS burden (NMSB), and thus may assist in the identification of an “at‐risk” CI group based on overall NMSB cutoff scores.MethodsTo investigate whether specific patterns of PD NMS profiles predict incident CI, we performed a retrospective longitudinal study on a convenience sample of 541 nondemented PD patients taking part in the Nonmotor Longitudinal International Study (NILS) cohort, with Mini‐Mental State Examination (MMSE), NMSS, and Scales for Outcomes in PD Motor Scale (SCOPA Motor) scores at baseline and last follow‐up (mean 3.2 years) being available.ResultsPD patients with incident CI (i.e., MMSE score ≤ 25) at last follow‐up (n = 107) had severe overall NMSB level, significantly worse NMSS hallucinations/perceptual problems and higher NMSS attention/memory scores at baseline. Patients with CI also were older and with more advanced disease, but with no differences in disease duration, dopamine replacement therapy, sex, and comorbid depression, anxiety, and sleep disorders.ConclusionsOur findings suggest that a comprehensive baseline measure of NMS and in particular hallucinations and perceptual problems assessed with a validated single instrument can be used to predict incident CI in PD. This approach provides a simple, holistic strategy to predict future CI in this population.
Highlights
Cognitive impairment (CI) is one of the most prominent and clinically relevant nonmotor features in Parkinson's disease (PD) (Aarsland et al, 2017), being an indicator for poor quality of life for patient as well as carers and having a significant impact on societal and institutionalization related costs (Goldman et al, 2018)
In an effort to identify possible clinical predictors of cognitive impairment (CI) in PD using one comprehensive tool, we aimed to explore two issues: (a) which out of the nine Nonmotor Symptoms Scale (NMSS) domains are associated with CI in PD patients, using a large-scale cohort and a “real-life” data mining- based analysis and (b) does a higher NMS burden (NMSB) at baseline predict to CI after 3 years
Data were analyzed from a cumulative cohort of PD patients recruited between November 2011 and July 2019, and only data from patients included in the United Kingdom were analyzed
Summary
Cognitive impairment (CI) is one of the most prominent and clinically relevant nonmotor features in Parkinson's disease (PD) (Aarsland et al, 2017), being an indicator for poor quality of life for patient as well as carers and having a significant impact on societal and institutionalization related costs (Goldman et al, 2018). Methods: To investigate whether specific patterns of PD NMS profiles predict incident CI, we performed a retrospective longitudinal study on a convenience sample of 541 nondemented PD patients taking part in the Nonmotor Longitudinal International Study (NILS) cohort, with Mini-Mental State Examination (MMSE), NMSS, and Scales for Outcomes in PD Motor Scale (SCOPA Motor) scores at baseline and last follow-up (mean 3.2 years) being available. Conclusions: Our findings suggest that a comprehensive baseline measure of NMS and in particular hallucinations and perceptual problems assessed with a validated single instrument can be used to predict incident CI in PD. This approach provides a Funding information Albert-L udwigs-Universität Freiburg: D637 simple, holistic strategy to predict future CI in this population
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