Skip to main content

Advertisement

SpringerLink
Log in

Mild cognitive impairment in Parkinson’s disease: the Parkinson’s disease cognitive study (PACOS)

  • Original Communication
  • Published:
Journal of Neurology Aims and scope Submit manuscript

Abstract

Approximately 30% of Parkinson’s disease (PD) patients show impaired cognitive performance, which is suggestive of Mild Cognitive Impairment (MCI), representing a predictor of dementia, especially when present at diagnosis. The objective of the study was to evaluate the frequency and clinical predictors of MCI in a large hospital-based cohort of PD patients. We collected cross-sectional data from the Parkinson’s disease cognitive impairment study (PACOS), a multicenter study involving two Movement Disorder centers, which are located in south Italy. The PD subjects were diagnosed according to the UK Brain Bank criteria and they underwent an extensive neuropsychological assessment. PD–MCI was diagnosed according to the Movement Disorder Society task force criteria for MCI. PD severity was evaluated in accordance with the Unified PD Rating Scale-Motor Examination (UPDRS-ME) and the Hoehn and Yahr scales. The study included 659 PD patients (57.5% men; mean age 67.0 ± 9.7 years), with a mean disease duration of 3.8 ± 4.6 years and a mean UPRDS-ME score of 25.8 ± 12.3. PD–MCI was diagnosed in 261 (39.6%) subjects and in 82 (31.7%) of 259 newly diagnosed patients (disease duration ≤ 1 year). An amnestic MCI multidomain phenotype was the most frequent MCI subtype (39.1% of the overall sample and 43.9% in newly diagnosed PD). A positive significant association between MCI, age and motor scores was found at multivariate logistic regression analysis, while a negative association was observed between educational level and MCI. In conclusion and in agreement with the literature data, the prevalence of MCI recorded in the PACOS sample was approximately 40 and 32% amongst newly diagnosed patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Williams-Gray CH, Mason SL, Evans JR et al (2013) The CamPaIGN study of Parkinson’s disease: 10-year outlook in an incident population-based cohort. J Neurol Neurosurg Psychiatry 84:1258–1264

    Article  PubMed  Google Scholar 

  2. Petersen RC (2004) Mild cognitive impairment as a diagnostic entity. J Intern Med 256:183–194

    Article  CAS  PubMed  Google Scholar 

  3. Litvan I, Goldman JG, Tröster AI et al (2012) Diagnostic criteria for mild cognitive impairment in Parkinson’s disease: movement Disorder Society Task Force guidelines. Mov Disord 27:349–356

    Article  PubMed  PubMed Central  Google Scholar 

  4. Pedersen KF, Larsen JP, Tysnes OB, Alves G (2013) Prognosis of mild cognitive impairment in early Parkinson disease: the Norwegian Park West Study. JAMA Neurol 70:580–586

    Article  PubMed  Google Scholar 

  5. Lawrence BJ, Gasson N, Loftus AM (2016) Prevalence and subtypes of mild cognitive impairment in Parkinson’s disease. Sci Rep 6:33929. https://doi.org/10.1038/srep33929

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  6. Cholerton BA, Zabetian CP, Wan JY et al (2014) Evaluation of mild cognitive impairment subtypes in Parkinson’s disease: MCI subtypes in Parkinson’s disease. Mov Disord 29:756–764

    Article  PubMed  PubMed Central  Google Scholar 

  7. Aarsland D, Creese B, Politis M et al (2017) Cognitive decline in Parkinson disease. Nat Rev Neurol 13:217–231

    Article  PubMed  PubMed Central  Google Scholar 

  8. Pedersen KF, Larsen JP, Tysnes OB, Alves G (2017) Natural course of mild cognitive impairment in Parkinson disease: a 5-year population-based study. Neurology 88:767–774

    Article  PubMed  Google Scholar 

  9. Domellöf ME, Ekman U, Forsgren L, Elgh E (2015) Cognitive function in the early phase of Parkinson’s disease, a five-year follow-up. Acta Neurol Scand 132:79–88

    Article  PubMed  Google Scholar 

  10. Hoogland J, Boel JA, de Bie RMA et al MDS Study Group “Validation of Mild Cognitive Impairment in Parkinson Disease” (2017) Mild cognitive impairment as a risk factor for Parkinson’s disease dementia: MCI as a risk factor for Parkinson’s disease dementia. Mov Disord 32:1056–1065

  11. Gibb WR, Lees AJ (1988) The relevance of the Lewy body to the pathogenesis of idiopathic Parkinson’s disease. J Neurol Neurosurg Psychiatry 51:745–752

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  12. Emre M, Aarsland D, Brown R et al (2007) Clinical diagnostic criteria for dementia associated with Parkinson’s disease. Mov Disord 22:1689–1707

    Article  PubMed  Google Scholar 

  13. Fahn S, Elton RL, the members of the UPDRS development committee (1987) Unified Parkinson’s Disease Rating Scale. In: Fahn S, Marsden CD, Calne DB (eds) Recent developments in Parkinson’s disease. MacMillan, London, pp 153–163

    Google Scholar 

  14. Hoehn MM, Yahr MD (1967) Parkinsonism: onset, progression, and mortality. Neurology 17:427–442

    Article  CAS  PubMed  Google Scholar 

  15. Stebbins GT, Goetz CG, Burn DJ, Jankovic J, Khoo TK, Tilley BC (2013) How to identify tremor dominant and postural instability/gait difficulty groups with the movement disorder society unified Parkinson’s disease rating scale. Mov Disord 28:668–670

    Article  PubMed  Google Scholar 

  16. Folstein MF, Folstein SE, McHugh PR (1975) ‘Mini-mental state’: a practical method for grading the cognitive state of patients for the clinician. J Psychiatr Res 12:189–198

    Article  CAS  PubMed  Google Scholar 

  17. Katz S, Ford AB, Moskowitz RW, Jackson BA, Jaffe MW (1963) Studies of illness in the aged. The index of ADL: a standardized measure of biological and psychosocial function. JAMA 185:914–919

    Article  CAS  PubMed  Google Scholar 

  18. Hughes CP, Berg L, Danziger WL, Coben LA, Martin RL (1982) A new clinical scale for the staging of dementia. Br J Psychiatry 140:566–572

    Article  CAS  PubMed  Google Scholar 

  19. Hamilton M (1960) A rating scale for depression. J Neurol Neurosurg Psychiatry 23:56–62

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  20. Schrag A, Barone P, Brown RG et al (2007) Depression rating scales in Parkinson’s disease: critique and recommendations. Mov Disord 22:1077–1092

    Article  PubMed  PubMed Central  Google Scholar 

  21. Novelli G, Papagno C, Capitani E et al (1986) Tre test clinici di memoria verbale a lungo termine: Taratura su soggetti normali. Arch Psicol Neurol Psichiatria 47:278–296

    Google Scholar 

  22. Novelli G, Papagno C, Capitani E et al (1986) Tre test clinici di ricerca e produzione lessicale. Taratura su soggetti normali. Archivio di Psicologia, Neurologia e Psichiatria 47:477–506

    Google Scholar 

  23. Spinnler H, Tognoni G (1987) Italian Group on the Neuropsychological Study of Ageing: Italian standardization and classification of neuropsychological tests. Ital J NeurolSci 6(suppl 8):1–120

    Google Scholar 

  24. Luzzatti C, Willmes K, De Bleser R et al (1994) New normative data for the Italian version of the Aachen Aphasia Test (AAT). Arch Psicol Neurol Psichiatria 55:1086–1131

    Google Scholar 

  25. Carlesimo GA, Caltagirone C, Gainotti G (1996) The Mental Deterioration Battery: normative data, diagnostic reliability and quantitative analyses of cognitive impairment. Eur Neurol 36:378–384

    Article  CAS  PubMed  Google Scholar 

  26. Giovagnoli AR, Del Pesce M, Mascheroni S, Simoncelli M, Laiacona M, Capitani E (1996) Trail making test: normative values from 287 normal adult controls. Ital J Neurol Sci 17:305–309

    Article  CAS  PubMed  Google Scholar 

  27. Caffarra P, Vezzadini G, Dieci F, Zonato F, Venneri A (2002) Una versione abbreviata del test di Stroop: dati normativi nella popolazione Italiana. Nuova Riv Neurol 12:111–115

    Google Scholar 

  28. Appollonio I, Leone M, Isella V et al (2005) The Frontal Assessment Battery (FAB): normative values in an Italian population sample. Neurol Sci 26:108–116

    Article  CAS  PubMed  Google Scholar 

  29. Caffarra P, Gardini S, Zonato F et al (2011) Italian norms for the Freedman version of the Clock Drawing Test. J Clin Exp Neuropsychol 33:982–988

    Article  PubMed  Google Scholar 

  30. Tomlinson CL, Stowe R, Patel S, Rick C, Gray R, Clarke CE (2010) Systematic review of levodopa dose equivalency reporting in Parkinson’s disease. Mov Disord 25:2649–2653

    Article  PubMed  Google Scholar 

  31. Litvan I, Aarsland D, Adler CH et al (2011) MDS task force on mild cognitive impairment in Parkinson’s disease: critical review of PD–MCI. Mov Disord 26:1814–1824

    Article  PubMed  PubMed Central  Google Scholar 

  32. Aarsland D, Bronnick K, Larsen JP, Tysnes OB, Alves G, Norwegian ParkWest Study Group (2009) Cognitive impairment in incident, untreated Parkinson disease: The Norwegian ParkWest Study. Neurology 72:1121–1126

    Article  CAS  PubMed  Google Scholar 

  33. Monastero R, Di Fiore P, Ventimiglia GD et al (2012) Prevalence and profile of mild cognitive impairment in Parkinson’s disease. Neurodegener Dis 10:187–190

    Article  CAS  PubMed  Google Scholar 

  34. Goldman JG, Holden S, Bernard B, Ouyang B, Goetz CG, Stebbins GT (2013) Defining optimal cutoff scores for cognitive impairment using Movement Disorder Society Task Force criteria for mild cognitive impairment in Parkinson’s disease. Mov Disord 28:1972–1979

    Article  PubMed  PubMed Central  Google Scholar 

  35. Marras C, Armstrong MJ, Meaney CA et al (2013) Measuring mild cognitive impairment in patients with Parkinson’s disease. Mov Disord 28:626–633

    Article  PubMed  PubMed Central  Google Scholar 

  36. Cholerton BA, Zabetian CP, Quinn JF et al (2013) Pacific Northwest Udall Center of excellence clinical consortium: study design and baseline cohort characteristics. J Park Dis 3:205–214

    Google Scholar 

  37. Yarnall AJ, Breen DP, Duncan GW et al (2014) Characterizing mild cognitive impairment in incident Parkinson disease The ICICLE-PD Study. Neurology 82:308–316

    Article  PubMed  PubMed Central  Google Scholar 

  38. Cereda E, Cilia R, Klersy C et al (2016) Dementia in Parkinson’s disease: is male gender a risk factor? Parkinsonism Relat Disord 26:67–72

    Article  PubMed  Google Scholar 

  39. Hu MTM, Szewczyk-Królikowski K, Tomlinson P et al (2014) Predictors of cognitive impairment in an early stage Parkinson’s disease cohort. Mov Disord 29:351–359

    Article  PubMed  PubMed Central  Google Scholar 

  40. Schrag A, Siddiqui UF, Anastasiou Z, Weintraub D, Schott JM (2017) Clinical variables and biomarkers in prediction of cognitive impairment in patients with newly diagnosed Parkinson’s disease: a cohort study. Lancet Neurol 16:66–75

    Article  CAS  PubMed  Google Scholar 

  41. Zhu K, van Hilten JJ, Marinus J (2014) Predictors of dementia in Parkinson’s disease; findings from a 5-year prospective study using the SCOPA-COG. Parkinsonism Relat Disord 20:980–985

    Article  PubMed  Google Scholar 

  42. Broeders M, De Bie RMA, Velseboer DC, Speelman JD, Muslimovic D, Schmand B (2013) Evolution of mild cognitive impairment in Parkinson disease. Neurology 81:346–352

    Article  CAS  PubMed  Google Scholar 

  43. Kalbe E, Rehberg SP, Heber I, Kronenbuerger M et al (2016) Subtypes of mild cognitive impairment in patients with Parkinson’s disease: evidence from the LANDSCAPE study. J Neurol Neurosurg Psychiatry 87:1099–1105

    Article  PubMed  Google Scholar 

  44. Santangelo G, Vitale C, Picillo M et al (2015) Mild Cognitive Impairment in newly diagnosed Parkinson’s disease: a longitudinal prospective study. Parkinsonism Relat Disord 21:1219–1226

    Article  PubMed  Google Scholar 

  45. Anang JB, Gagnon JF, Bertrand JA et al (2014) Predictors of dementia in Parkinson disease: a prospective cohort study. Neurology 83:1253–1260

    Article  PubMed  PubMed Central  Google Scholar 

  46. Perez-Lloret S, Barrantes FJ (2016) Deficits in cholinergic neurotransmission and their clinical correlates in Parkinson’s disease. NPJ Parkinson Dis 18(2):16001. https://doi.org/10.1038/npjparkd.2016.1

    Article  Google Scholar 

  47. Kehagia AA, Barker RA, Robbins TW (2013) Cognitive impairment in Parkinson’s disease: the dual syndrome hypothesis. Neurodegener Dis 11:79–92

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Roberto Monastero and Alessandra Nicoletti are the principal investigators of the PACOS, being involved in the study’s conception and design. They participated in the study organization and data collection, planned statistical analyses and participated in manuscript writing and critical revision. Calogero Edoardo Cicero was involved in the study data collection; he ran the statistical analysis and wrote the first draft of the manuscript. Roberta Baschi was involved in the study data collection, neuropsychological assessment and manuscript critical revision. Marco Davì was involved in the study data collection and manuscript critical revision. Antonina Luca was involved in the study data collection, neuropsychological assessment and manuscript critical revision. Vincenzo Restivo was involved in the study data management and manuscript critical revision. Chiara Zangara was involved in the study data collection and manuscript critical revision. Brigida Fierro was involved in manuscript critical revision. Mario Zappia was involved in manuscript critical revision.

Funding

This research did not receive any specific grants from funding agencies in the public, commercial, or not-for-profit sectors.

Author information

Author notes

  1. Roberto Monastero and Calogero Edoardo Cicero contributed equally to the manuscript.

Authors and Affiliations

  1. Department of Experimental Biomedicine and Clinical Neurosciences, Section of Neurology, University of Palermo, Via La Loggia 1, 90129, Palermo, Italy

    Roberto Monastero, Roberta Baschi, Marco Davì & Brigida Fierro

  2. Department G.F. Ingrassia, Section of Neurosciences, University of Catania, Via Santa Sofia 79, 95123, Catania, Italy

    Calogero Edoardo Cicero, Antonina Luca, Chiara Zangara, Mario Zappia & Alessandra Nicoletti

  3. Department of Sciences for Health Promotion and Mother–Child Care, University of Palermo, Via Del Vespro 133, 90127, Palermo, Italy

    Vincenzo Restivo

Authors
  1. Roberto Monastero
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Calogero Edoardo Cicero
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Roberta Baschi
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marco Davì
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Antonina Luca
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Vincenzo Restivo
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Chiara Zangara
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Brigida Fierro
    View author publications

    You can also search for this author in PubMed Google Scholar

  9. Mario Zappia
    View author publications

    You can also search for this author in PubMed Google Scholar

  10. Alessandra Nicoletti
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Roberto Monastero or Alessandra Nicoletti.

Ethics declarations

Ethical standards

The study was conducted according to the ethical standards of the declaration of Helsinki and later amendments. It was also approved by the local medical Ethics Committee, and written informed consent was obtained from each patient prior to entering the study.

Conflict of interests

The authors declare that they have no conflict of interest regarding this research.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary material 1 (DOCX 18 kb)

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Monastero, R., Cicero, C.E., Baschi, R. et al. Mild cognitive impairment in Parkinson’s disease: the Parkinson’s disease cognitive study (PACOS). J Neurol 265, 1050–1058 (2018). https://doi.org/10.1007/s00415-018-8800-4

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00415-018-8800-4

Keywords

Search

Navigation