scholarly journals Estimation of Cognitive Performance Based on Premorbid Intelligence in Parkinson’s Disease

2020 ◽  
Vol 10 (4) ◽  
pp. 1717-1725
Author(s):  
Rocio Del Pino ◽  
Maria Díez-Cirarda ◽  
Javier Peña ◽  
Naroa Ibarretxe-Bilbao ◽  
Natalia Ojeda

Background: The estimation of premorbid intelligence (PI) is needed for an accurate diagnosis. Objective: This study aimed to estimate the cognitive performance taking into account the PI in Parkinson’s disease (PD) compared to healthy controls (HC); and to analyze the discrepancies between the current and the predicted cognitive performance based on the PI. Method: Semantic fluency, verbal and visual memory, and executive functions were assessed in 39 PD and 162 HC. A linear regression model was used to analyze the discrepancies between the predicted cognitive performance and the current raw scores through PI variables (Word Accentuation Test (WAT), Pseudo-Words (PW) Reading subtest from PROLEC-R, age, and years of education). ROC analyses were performed to assess their diagnostic properties. Results: Significant differences were found in the raw cognitive scores between patients and HC [semantic fluency (t = 6.07; p < 0.001), verbal memory (t = 6.63; p < 0.001), and executive functions (t = 2.57; p = 0.013), and in visual memory (t = 1.97; p = 0.055 marginally significant)]. Compared to HC, PD patients presented higher discrepancies between the predicted cognitive performance and the raw scores in semantic fluency, verbal memory, visual memory, executive functions (AUC = 0.78, 0.78; 0.64, 0.61, respectively). Conclusion: The magnitude of the discrepancies scores between the current and the predicted cognitive performance based on PI indicates the presence of cognitive decline in the specific cognitive domain in PD patients. This study underlines the usefulness of premorbid measures and variables, such as WAT, PW, age, and years of education, to more accurately estimate the cognitive performance in PD.

2006 ◽  
Vol 12 (5) ◽  
pp. 736-740 ◽  
Author(s):  
M.M. AMICK ◽  
J. GRACE ◽  
K.L. CHOU

The relation of body side of motor symptom onset in Parkinson's disease (PD) to memory measures associated with hemispheric dominance was examined. Fourteen patients with right body side motor symptom onset (RPD, inferred left hemisphere dysfunction) and 16 patients with left side onset (LPD, right hemisphere dysfunction) were administered measures of verbal (Hopkins Verbal Learning Test-Revised) and visual memory (Brief Visual Memory Test-Revised), that require similar task demands and are associated with left or right hemisphere dominance, respectively. The LPD group demonstrated poorer visual than verbal memory, both within group and in comparison to the RPD group. By contrast, the RPD group showed poorer verbal than visual memory within group. These findings suggest that side of motor symptom onset is associated with asymmetrical memory dysfunction (JINS, 2006, 12, 736–740.)


2017 ◽  
Vol 24 (3) ◽  
pp. 269-282 ◽  
Author(s):  
Sarah M. Szymkowicz ◽  
Vonetta M. Dotson ◽  
Jacob D. Jones ◽  
Michael S. Okun ◽  
Dawn Bowers

AbstractObjectives: Both depression and apathy, alone and in combination, have been shown to negatively affect cognition in patients with Parkinson’s disease (PD). However, the influence of specific symptom dimensions of depression and apathy on cognition is not well understood. The current study investigated the relationship between symptom dimensions of depression and apathy, based on factors identified in Kirsch-Darrow et al. (2011), and memory and executive function in PD. Methods: A sample of 138 non-demented individuals with PD (mean age=64.51±7.43 years) underwent neuropsychological testing and completed the Beck Depression Inventory, 2nd Edition, and Apathy Scale. Separate hierarchical regression models examined the relationship between symptom dimensions of depression and apathy (“pure” depressive symptoms, “pure” apathy, loss of interest/pleasure [anhedonia], and somatic symptoms) and three cognitive domain composites: immediate verbal memory, delayed verbal memory, and executive function. Results: After adjusting for general cognitive status and the influence of the other symptom dimensions, “pure” depressive symptoms were negatively associated with the delayed verbal memory composite (p<.034) and somatic symptoms were positively associated with the executive function composite (p<.026). No symptom dimensions were significantly related to the immediate verbal memory composite. Conclusions: Findings suggest that specific mood symptoms are associated with delayed verbal memory and executive function performance in non-demented patients with PD. Further research is needed to better understand possible mechanisms through which specific symptom dimensions of depression and apathy are associated with cognition in PD. (JINS, 2018, 24, 269–282)


2020 ◽  
Author(s):  
Shi Rong Wen ◽  
Guang Yang ◽  
Si Jia Xu ◽  
Yan Liu ◽  
Yu Jun Pan

Abstract Background: The predictive value of subjective cognitive decline in Parkinson's disease (PD-SCD) remains controversial. However, there is growing evidence that individuals with subjective cognitive decline (SCD) are associated with Alzheimer's disease pathology and are a higher risk for cognitive decline. The aim of the present study is to characterize PD-SCD and its progression, assess the effects of rehabilitation training programs on cognitive function in PD patients.Methods: Forty-two PD patients were evaluated with a neuropsychological protocol, and classified depending on the presence (PD-SCD+, n=22) or absence of SCD (PD-SCD-,n=20). After a mean follow-up of 3.0 years (2.0-4.0 years), we repeated the cognitive assessments with the same subjects. The rehabilitation training for individuals with PD for six months after the re-assessment.Results: The clinical characteristics and overall cognitive performance of the 2 groups did not differ from baseline. During the follow-up assessment, patients with PD-SCD exhibited a more significant annual decline in Chinese-Beijing version of Montreal Cognitive Assessment-Test (BJ-MoCA) and semantic fluency than patients without PD-SCD. Stepwise logistic regression analysis showed that the MMSE Scores(P=0.000), HAMD Scores (P=0.008), male (P=0.026), and the presence of SCD (P=0.022) were risk factors for language and related functions domain. There are significant improvements detected in 2 groups after rehabilitation training in terms of BJ-MoCA. Pairwise comparisons showed that language at post-intervention in the PD-SCD+ groups were significantly higher than at pre-intervention in the PD-SCD-.Conclusion: With the progression of the disease, the cognitive performance of patients with PD-SCD+ was worse than PD-SCD-. Meanwhile, the present data indicate that semantic fluency might be a key component to evaluate the cognitive subset of PD. Rehabilitation training is a viable intervention for PD that can improve several non-motor domains, produced larger improvements in cognition.


2021 ◽  
Vol 11 (8) ◽  
pp. 992
Author(s):  
Andrea M. Loftus ◽  
Natalie Gasson ◽  
Nicole Lopez ◽  
Michelle Sellner ◽  
Carly Reid ◽  
...  

Cognitive impairment is acknowledged as a feature of Parkinson’s disease (PD), and the most common cognitive declines are in executive function (EF) and memory. Cognitive reserve (CR) may offer some protection against cognitive dysfunction in PD. The present study used two proxies of CR (years of education, premorbid IQ) to examine the relationship between CR and (i) EF (ii) memory in a large PD sample (n = 334). Two aspects of EF were examined, including verbal fluency and planning skills. Two aspects of verbal memory were examined, including immediate recall and delayed recall. For EF, both CR proxies significantly predicted verbal fluency, but only years of education predicted planning skills. Years of education significantly predicted immediate recall, but premorbid IQ did not. Neither CR proxy predicted delayed recall. These findings suggest that CR, in particular years of education, may contribute to EF and memory function in those with PD. A key finding of this study is the varying contribution of CR proxies to different aspects of the same cognitive domain. The findings indicate that using only one proxy has the potential to be misleading and suggest that when testing the relationship between CR and cognition, studies should include tasks that measure different aspects of the cognitive domain(s) of interest.


2019 ◽  
Vol 19 (7) ◽  
pp. 1022-1031 ◽  
Author(s):  
Paula D. Cebrián ◽  
Omar Cauli

Background: Many neurological disorders lead to institutionalization and can be accompanied in their advanced stages by functional impairment, and progressive loss of mobility, and cognitive alterations. Objective: We analyzed the relationship between functional impairment and cognitive performance and its related subdomains in individuals with Parkinson’s disease, Alzheimer’s disease accompanied by motor dysfunction, and with other neurological disorders characterized by both motor and cognitive problems. Methods: All participants lived in nursing homes (Valencia, Spain) and underwent cognitive evaluation with the Mini-Mental State Examination; functional assessment of independence in activities of daily living using the Barthel score and Katz index; and assessment of mobility with the elderly mobility scale. Results: The mean age of the subjects was 82.8 ± 0.6 years, 47% of the sample included individuals with Parkinson’s disease, and 48 % of the sample presented severe cognitive impairment. Direct significant relationships were found between the level of cognitive impairment and functional capacity (p < 0.01) and mobility (p < 0.05). Among the different domains, memory impairment was not associated with altered activities of daily living or mobility. The functional impairment and the risk of severe cognitive impairment were significantly (p<0.05) higher in female compared to male patients. Among comorbidities, overweight/obesity and diabetes were significantly (p < 0.05) associated with poor cognitive performance in those individuals with mild/moderate cognitive impairment. Conclusion: In institutionalized individuals with movement disorders there is an association between functional and cognitive impairment. Reduction of over-weight and proper control of diabetes may represent novel targets for improving cognitive function at such early stages.


2021 ◽  
pp. 1-3
Author(s):  
Tobias Loetscher

BACKGROUND: The majority of people living with Parkinson’s disease will develop impairments in cognition. These impairments are associated with a reduced quality of life. OBJECTIVE: The Cochrane Review aimed to investigate whether cognitive training improves cognition in people with Parkinson’s disease and mild cognitive impairments or dementia. METHODS: A Cochrane Review by Orgeta et al. was summarized with comments. RESULTS: The review included seven studies with a total of 225 participants. There was no evidence for improvements in global cognition when cognitive training was compared to control conditions. Observed improvements in attention and verbal memory measures after cognitive training could not be confirmed in a subsequent sensitivity analysis. There was no evidence for benefits in other cognitive domains or quality of life measures. The certainty of the evidence was low for all comparisons. CONCLUSIONS: The effectiveness of cognitive training for people with Parkinson’s disease and cognitive impairments remains inconclusive. There is a pressing need for adequately powered trials with higher methodological quality.


2021 ◽  
pp. 1-12
Author(s):  
Rachael A. Lawson ◽  
Caroline H. Williams-Gray ◽  
Marta Camacho ◽  
Gordon W. Duncan ◽  
Tien K. Khoo ◽  
...  

Background: Cognitive impairment is common in Parkinson’s disease (PD), with 80% cumulatively developing dementia (PDD). Objective: We sought to identify tests that are sensitive to change over time above normal ageing so as to refine the neuropsychological tests predictive of PDD. Methods: Participants with newly diagnosed PD (n = 211) and age-matched controls (n = 99) completed a range of clinical and neuropsychological tests as part of the ICICLE-PD study at 18-month intervals over 72 months. Impairments on tests were determined using control means (<1-2SD) and median scores. Mild cognitive impairment (PD-MCI) was classified using 1-2SD below normative values. Linear mixed effects modelling assessed cognitive decline, while Cox regression identified baseline predictors of PDD. Results: At 72 months, 46 (cumulative probability 33.9%) participants had developed PDD; these participants declined at a faster rate in tests of global cognition, verbal fluency, memory and attention (p <  0.05) compared to those who remained dementia-free. Impaired baseline global cognition, visual memory and attention using median cut-offs were the best predictors of early PDD (area under the curve [AUC] = 0.88, p <  0.001) compared to control-generated cut-offs (AUC = 0.76–0.84, p <  0.001) and PD-MCI (AUC] = 0.64–0.81, p <  0.001). Impaired global cognition and semantic fluency were the most useful brief tests employable in a clinical setting (AUC = 0.79, p <  0.001). Conclusion: Verbal fluency, attention and memory were sensitive to change in early PDD and may be suitable tests to measure therapeutic response in future interventions. Impaired global cognition, attention and visual memory were the most accurate predictors for developing a PDD. Future studies could consider adopting these tests for patient clinical trial stratification.


2021 ◽  
pp. 1-9
Author(s):  
Travis H. Turner ◽  
Alexandra Atkins ◽  
Richard S.E. Keefe

Background: Cognitive impairment is common in Parkinson’s disease (PD) and highly associated with loss of independence, caregiver burden, and assisted living placement. The need for cognitive functional capacity tools validated for use in PD clinical and research applications has thus been emphasized in the literature. The Virtual Reality Functional Capacity Assessment Tool (VRFCAT-SL) is a tablet-based instrument that assesses proficiency for performing real world tasks in a highly realistic environment. Objective: The present study explored application of the VRFCAT-SL in clinical assessments of patients with PD. Specifically, we examined associations between VRFCAT-SL performance and measures of cognition, motor severity, and self-reported cognitive functioning. Methods: The VRFCAT-SL was completed by a sample of 29 PD patients seen in clinic for a comprehensive neuropsychological evaluation. Fifteen patients met Movement Disorders Society Task Force criteria for mild cognitive impairment (PD-MCI); no patients were diagnosed with dementia. Non-parametric correlations between VRFCAT-SL performance and standardized neuropsychological tests and clinical measures were examined. Results: VRFCAT-SL performance was moderately associated with global rank on neuropsychological testing and discriminated PD-MCI. Follow-up analyses found completion time was associated with visual memory, sustained attention, and set-switching, while errors were associated with psychomotor inhibition. No clinical or motor measures were associated with VRFCAT-SL performance. Self-report was not associated with VRFCAT-SL or neuropsychological test performance. Conclusion: The VRFCAT-SL appears to provide a useful measure of cognitive functional capacity that is not confounded by PD motor symptoms. Future studies will examine utility in PD dementia.


Gerontology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Ram kinker Mishra ◽  
Catherine Park ◽  
He Zhou ◽  
Bijan Najafi ◽  
T. Adam Thrasher

<b><i>Introduction:</i></b> Parkinson’s disease (PD) progressively impairs motor and cognitive performance. The current tools to detect decline in motor and cognitive functioning are often impractical for busy clinics and home settings. To address the gap, we designed an instrumented trail-making task (iTMT) based on a wearable sensor (worn on the shin) with interactive game-based software installed on a tablet. The iTMT test includes reaching to 5 indexed circles, a combination of numbers (1–3) and letters (A&amp;B) randomly positioned inside target circles, in a sequential order, which virtually appears on a screen kept in front of the participants, by rotating one’s ankle joint while standing and holding a chair for safety. By measuring time to complete iTMT task (iTMT time), iTMT enables quantifying cognitive-motor performance. <b><i>Purpose:</i></b> This study’s objective is to examine the feasibility of iTMT to detect early cognitive-motor decline in PDs. <b><i>Method:</i></b> Three groups of volunteers, including 14 cognitively normal (CN) older adults, 14 PDs, and 11 mild cognitive impaireds (MCI), were recruited. Participants completed MoCA, 20 m walking test, and 3 trials of iTMT. <b><i>Results:</i></b> All participants enabled to complete iTMT with &#x3c;3 min, indicating high feasibility. The average iTMT time for CN-Older, PD, and MCI participants were 20.9 ± 0.9 s, 32.3 ± 2.4 s, and 40.9 ± 4.5 s, respectively. After adjusting for age and education level, pairwise comparison suggested large effect sizes for iTMT between CN-older versus PD (Cohen’s <i>d</i> = 1.7, <i>p</i> = 0.024) and CN-older versus MCI (<i>d</i> = 1.57, <i>p</i> &#x3c; 0.01). Significant correlations were observed when comparing iTMT time with the gait speed (<i>r</i> = −0.4, <i>p</i> = 0.011) and MoCA score (<i>r</i> = −0.56, <i>p</i> &#x3c; 0.01). <b><i>Conclusion:</i></b> This study demonstrated the feasibility and early results supporting the potential application of iTMT to determine cognitive-motor and distinguishing individuals with MCI and PD from CN-older adults. Future studies are warranted to test the ability of iTMT to track its subtle changes over time.


2015 ◽  
Vol 5 (3) ◽  
pp. 613-620 ◽  
Author(s):  
Thomas F. Münte ◽  
Gregor Joppich ◽  
Jan Däuper ◽  
Christoph Schrader ◽  
Reinhard Dengler ◽  
...  

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