Evolution of mild cognitive impairment in Parkinson disease

• Published in: Neurology Vol. 81; no. 4; pp. 346 - 352
• Main Authors: Broeders, M, de Bie, R.M.A, Velseboer, D.C, Speelman, J.D, Muslimovic, D, Schmand, B
• Format: Journal Article
• Language: English
• Published: Hagerstown, MD by AAN Enterprises, Inc 23-07-2013; Lippincott Williams & Wilkins
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Cognitive Dysfunction - diagnosis; Cognitive Dysfunction - etiology; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Disease Progression; Female; Humans; Longitudinal Studies; Male; Medical sciences; Middle Aged; Neurologic Examination; Neurology; Neuropsychological Tests; Parkinson Disease - complications; Parkinson Disease - psychology; Reproducibility of Results; Retrospective Studies; Nervous system diseases; Cognitive disorder; Central nervous system disease; Parkinson disease; Evolution; Degenerative disease; mild cognitive impairment; Cerebral disorder; Extrapyramidal syndrome
• ISSN: 0028-3878; 1526-632X
• DOI: 10.1212/WNL.0b013e31829c5c86

OBJECTIVE:We examined the development of Parkinson disease (PD)–mild cognitive impairment (MCI) in patients with newly diagnosed PD over 5 years using recently proposed consensus criteria, and we assessed the reliability of the criteria.
METHODS:Patients with PD (n = 123) underwent extensive neuropsychological testing at baseline and after 3 (n = 93) and 5 years (n = 59). Two neuropsychologists independently applied the PD-MCI criteria to examine the interrater and intrarater reliability.
RESULTS:At baseline, 35% of patients had PD-MCI. Three years later, 53% of the patients had PD-MCI. At 5-year follow-up, 20 patients who had PD-MCI at an earlier assessment had converted to PD dementia and 50% of the remaining patients without dementia had MCI. The interrater reliability (kappa) was 0.91. The intrarater reliabilities were 0.85 and 0.96.
CONCLUSION:Approximately one-third of patients with newly diagnosed PD fulfill the consensus criteria for PD-MCI; after 5 years, this proportion is approximately 50% of patients without dementia. The criteria have good interrater and intrarater reliability.