Abstract
Aim. This study sought to establish the discriminant validity of a rapid cognitive screen, that is, the National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute protocol, and compare its discriminant validity to the Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) in detecting cognitive impairment (CI) in PD patients. Methods. One hundred and one PD patients were recruited from a movement disorders clinic in Singapore and they received the NINDS-CSN 5-minute protocol, MoCA, and MMSE. No cognitive impairment (NCI) was defined as Clinical Dementia Rating (CDR) = 0 and CI was defined as CDR ≥ 0.5. Results. Area under the receiver operating characteristic curve of NINDS-CSN 5-minute protocol was statistically equivalent to MoCA and larger than MMSE (0.86 versus 0.90, P = 0.07; 0.86 versus 0.76, P = 0.03). The sensitivity of NINDS-CSN 5-minute protocol (<9) was statistically equivalent to MoCA (<22) (0.77 versus 0.85, P = 0.13) and superior to MMSE (<24) (0.77 versus 0.52, P < 0.01) in detecting CI, while the specificity of NINDS-CSN 5-minute protocol (<9) was statistically equivalent to MoCA (<22) and MMSE (<24) (0.78 versus 0.88, P = 0.34). Conclusion. The NINDS-CSN 5-minute protocol is time expeditious while remaining statistically equivalent to MoCA and superior to MMSE and therefore is suitable for rapid cognitive screening of CI in PD patients.
Highlights
Parkinson’s disease (PD) is the second most common chronic neurodegenerative disorder with a global prevalence of 0.5% to 4% in older adults aged ≥65 years [1]
This study sought to establish the discriminant validity of a rapid cognitive screen, that is, the National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) 5-minute protocol, and compare its discriminant validity to the Montreal Cognitive Assessment (MoCA) and Mini Mental State Examination (MMSE) in detecting cognitive impairment (CI) in PD patients
The National Institute of Neurological Disease and Stroke-Canadian Stroke Network (NINDS-CSN) recommended a 5-minute protocol drawn from the MoCA for rapid screening of poststroke vascular cognitive impairment (VCI) [5]
Summary
Parkinson’s disease (PD) is the second most common chronic neurodegenerative disorder with a global prevalence of 0.5% to 4% in older adults aged ≥65 years [1]. The cumulative prevalence of PD dementia over 8 years is approximately 80% in patients whose mean PD duration was 9 years at baseline [2]. One-third of idiopathic PD patients in Singapore showed cognitive decline at an early stage of the disease [3]. Patients with PD are a “population at risk” for cognitive impairment and require cognitive screening. Suffer from a reduced quality of life and increased caregiver burden and require long-term management [4]. Rapid screening for CI is an important step in achieving optimal long-term care for PD patients
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