Abstract
IntroductionAs cognitive-driven worsening of activities of the daily living (ADL) in Parkinson’s disease (PD) is the core feature of PD dementia (PDD), there is great need for sensitive quantitative assessment. Aim of our study was the evaluation of cognitive-driven worsening of ADL by the performance-based Multiple Object Test (MOT), offering an essential clinical advantage as it is quick and easy to apply in a clinical context even on severely impaired patients.Methods73 PD patients were assessed longitudinally over a period of 37 (6–49) months. According to their neuropsychological profile the sample was divided into two groups: PD patients with (n = 34, PD-CI) and without cognitive impairment (n = 39, PD-noCI). The MOT comprises five routine tasks (e.g. to make coffee) quick and easy to apply. Quantitative (total error number, processing time) and qualitative parameters (error type) were analyzed using non-parametric test statistic (e.g.Wilcoxon signed-rank test, binary logistic regression).ResultsMedian number of total errors (p = 0.001), processing time (p<0.001), perplexity (p = 0.035), and omission errors (p<0.001) increased significantly from baseline to follow-up in the total sample. Worsening of MOT performance was correlated to cognitive decline in the attention/ executive function and visuo-constructive domain. PD-CI showed an increase in omission errors (p = 0.027) compared to PD-noCI over time. This increase in omission errors between visits was further identified as a risk marker for PDD conversion.ConclusionThe MOT, especially frequency of omission errors, is a promising tool to rate PD patients objectively and might help to identify patients with a high risk for having mild cognitive impairment or dementia.
Highlights
As cognitive-driven worsening of activities of the daily living (ADL) in Parkinson’s disease (PD) is the core feature of PD dementia (PDD), there is great need for sensitive quantitative assessment
This increase in omission errors between visits was further identified as a risk marker for PDD conversion
Impairment in activity of daily living (ADL) function is the most crucial characteristic to differentiate between mild cognitive impairment and early stage dementia [1, 2]
Summary
73 PD patients were assessed longitudinally over a period of 37 (6–49) months. According to their neuropsychological profile the sample was divided into two groups: PD patients with (n = 34, PD-CI) and without cognitive impairment (n = 39, PD-noCI). 131 idiopathic PD patients diagnosed according to the United Kingdom Parkinson’s Disease Society Brain Bank criteria [14] were recruited from the outpatient Parkinson’s clinic of the University hospital of Tuebingen. The study was approved by the ethics committee of the Medical Faculty, University of Tuebingen, Germany; all patients gave written informed consent. Neuropsychological assessment was conducted by a neuropsychologist or trained research staff
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