Measuring Mild Cognitive Impairment in Patients With Parkinson’s Disease
Identifieur interne : 000918 ( Main/Merge ); précédent : 000917; suivant : 000919Measuring Mild Cognitive Impairment in Patients With Parkinson’s Disease
Auteurs : Connie Marras [Canada] ; Melissa J. Armstrong [Canada] ; Christopher A. Meaney [Canada] ; Susan Fox [Canada] ; Brandon Rothberg [Canada] ; William Reginold [Canada] ; David F. Tang-Wai [Canada] ; David Gill [États-Unis] ; Paul J. Eslinger [États-Unis] ; Cindy Zadikoff [États-Unis] ; Nancy Kennedy [États-Unis] ; Fred J. Marshall [États-Unis] ; Mark Mapstone [États-Unis] ; Kelvin L. Chou [États-Unis] ; Carol Persad [États-Unis] ; Irene Litvan [États-Unis] ; Benjamin T. Mast [États-Unis] ; Adam T. Gerstenecker [États-Unis] ; Sandra Weintraub [États-Unis] ; Sarah Duff-Canning [Canada]Source :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2013.
English descriptors
- KwdEn :
- MESH :
- complications : Parkinson Disease.
- diagnosis : Mild Cognitive Impairment.
- etiology : Mild Cognitive Impairment.
- Aged, Female, Humans, Male, Mental Status Schedule, Middle Aged, Neuropsychological Tests, ROC Curve, Retrospective Studies.
Abstract
We examined the frequency of Parkinson disease with mild cognitive impairment (PD-MCI) and its subtypes and the accuracy of 3 cognitive scales for detecting PD-MCI using the new criteria for PD-MCI proposed by the Movement Disorders Society. Nondemented patients with Parkinson’s disease completed a clinical visit with the 3 screening tests followed 1 to 3 weeks later by neuropsychological testing. Of 139 patients, 46 met Level 2 Task Force criteria for PD-MCI when impaired performance was based on comparisons with normative scores. Forty-two patients (93%) had multi-domain MCI. At the lowest cutoff levels that provided at least 80% sensitivity, specificity was 44% for the Montreal Cognitive Assessment and 33% for the Scales for Outcomes in Parkinson’s Disease-Cognition. The Mini-Mental State Examination could not achieve 80% sensitivity at any cutoff score. At the highest cutoff levels that provided specificity of at least 80%, sensitivities were low (≤44%) for all tests. When decline from estimated premorbid levels was considered evidence of cognitive impairment, 110 of 139 patients were classified with PD-MCI, and 103 (94%) had multi-domain MCI. We observed dramatic differences in the proportion of patients who had PD-MCI using the new Level 2 criteria, depending on whether or not decline from premorbid level of intellectual function was considered. Recommendations for methods of operationalizing decline from premorbid levels constitute an unmet need. Among the 3 screening tests examined, none of the instruments provided good combined sensitivity and specificity for PD-MCI. Other tests recommended by the Task Force Level 1 criteria may represent better choices, and these should be the subject of future research.
Url:
DOI: 10.1002/mds.25426
PubMed: 23520128
PubMed Central: 4524474
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PMC:4524474Le document en format XML
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<author><name sortKey="Reginold, William" sort="Reginold, William" uniqKey="Reginold W" first="William" last="Reginold">William Reginold</name>
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<author><name sortKey="Tang Wai, David F" sort="Tang Wai, David F" uniqKey="Tang Wai D" first="David F." last="Tang-Wai">David F. Tang-Wai</name>
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<author><name sortKey="Chou, Kelvin L" sort="Chou, Kelvin L" uniqKey="Chou K" first="Kelvin L." last="Chou">Kelvin L. Chou</name>
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<author><name sortKey="Persad, Carol" sort="Persad, Carol" uniqKey="Persad C" first="Carol" last="Persad">Carol Persad</name>
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<author><name sortKey="Duff Canning, Sarah" sort="Duff Canning, Sarah" uniqKey="Duff Canning S" first="Sarah" last="Duff-Canning">Sarah Duff-Canning</name>
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<wicri:regionArea>Department of Neuropsychology, Toronto Western Hospital, Toronto, Ontario</wicri:regionArea>
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<author><name sortKey="Reginold, William" sort="Reginold, William" uniqKey="Reginold W" first="William" last="Reginold">William Reginold</name>
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<author><name sortKey="Tang Wai, David F" sort="Tang Wai, David F" uniqKey="Tang Wai D" first="David F." last="Tang-Wai">David F. Tang-Wai</name>
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<author><name sortKey="Gill, David" sort="Gill, David" uniqKey="Gill D" first="David" last="Gill">David Gill</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, Penn State Hershey, Hershey, Pennsylvania</wicri:regionArea>
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<author><name sortKey="Eslinger, Paul J" sort="Eslinger, Paul J" uniqKey="Eslinger P" first="Paul J." last="Eslinger">Paul J. Eslinger</name>
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<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, Penn State Hershey, Hershey, Pennsylvania</wicri:regionArea>
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</placeName>
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<author><name sortKey="Zadikoff, Cindy" sort="Zadikoff, Cindy" uniqKey="Zadikoff C" first="Cindy" last="Zadikoff">Cindy Zadikoff</name>
<affiliation wicri:level="2"><nlm:aff id="A6">Department of Neurology, Northwestern University, Chicago, Illinois, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, Northwestern University, Chicago, Illinois</wicri:regionArea>
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</affiliation>
</author>
<author><name sortKey="Kennedy, Nancy" sort="Kennedy, Nancy" uniqKey="Kennedy N" first="Nancy" last="Kennedy">Nancy Kennedy</name>
<affiliation wicri:level="2"><nlm:aff id="A7">Department of Psychiatry and Behavioral Science, Northwestern University, Chicago, Illinois, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Psychiatry and Behavioral Science, Northwestern University, Chicago, Illinois</wicri:regionArea>
<placeName><region type="state">Illinois</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Marshall, Fred J" sort="Marshall, Fred J" uniqKey="Marshall F" first="Fred J." last="Marshall">Fred J. Marshall</name>
<affiliation wicri:level="2"><nlm:aff id="A8">Department of Neurology, University of Rochester, Rochester, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, University of Rochester, Rochester, New York</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mapstone, Mark" sort="Mapstone, Mark" uniqKey="Mapstone M" first="Mark" last="Mapstone">Mark Mapstone</name>
<affiliation wicri:level="2"><nlm:aff id="A8">Department of Neurology, University of Rochester, Rochester, New York, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, University of Rochester, Rochester, New York</wicri:regionArea>
<placeName><region type="state">État de New York</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Chou, Kelvin L" sort="Chou, Kelvin L" uniqKey="Chou K" first="Kelvin L." last="Chou">Kelvin L. Chou</name>
<affiliation wicri:level="2"><nlm:aff id="A9">Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, University of Michigan, Ann Arbor, Michigan</wicri:regionArea>
<placeName><region type="state">Michigan</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Persad, Carol" sort="Persad, Carol" uniqKey="Persad C" first="Carol" last="Persad">Carol Persad</name>
<affiliation wicri:level="2"><nlm:aff id="A10">Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Psychiatry, University of Michigan, Ann Arbor, Michigan</wicri:regionArea>
<placeName><region type="state">Michigan</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Litvan, Irene" sort="Litvan, Irene" uniqKey="Litvan I" first="Irene" last="Litvan">Irene Litvan</name>
<affiliation wicri:level="2"><nlm:aff id="A11">Department of Neurology, University of Louisville, Louisville, Kentucky, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, University of Louisville, Louisville, Kentucky</wicri:regionArea>
<placeName><region type="state">Kentucky</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mast, Benjamin T" sort="Mast, Benjamin T" uniqKey="Mast B" first="Benjamin T." last="Mast">Benjamin T. Mast</name>
<affiliation wicri:level="2"><nlm:aff id="A12">Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky</wicri:regionArea>
<placeName><region type="state">Kentucky</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Gerstenecker, Adam T" sort="Gerstenecker, Adam T" uniqKey="Gerstenecker A" first="Adam T." last="Gerstenecker">Adam T. Gerstenecker</name>
<affiliation wicri:level="2"><nlm:aff id="A12">Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Psychological & Brain Sciences, University of Louisville, Louisville, Kentucky</wicri:regionArea>
<placeName><region type="state">Kentucky</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Weintraub, Sandra" sort="Weintraub, Sandra" uniqKey="Weintraub S" first="Sandra" last="Weintraub">Sandra Weintraub</name>
<affiliation wicri:level="2"><nlm:aff id="A13">Department of Cognitive Neurology and Alzheimer’s Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA</nlm:aff>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Cognitive Neurology and Alzheimer’s Disease Center, Northwestern University Feinberg School of Medicine, Chicago, Illinois</wicri:regionArea>
<placeName><region type="state">Illinois</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Duff Canning, Sarah" sort="Duff Canning, Sarah" uniqKey="Duff Canning S" first="Sarah" last="Duff-Canning">Sarah Duff-Canning</name>
<affiliation wicri:level="1"><nlm:aff id="A14">Department of Neuropsychology, Toronto Western Hospital, Toronto, Ontario, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Department of Neuropsychology, Toronto Western Hospital, Toronto, Ontario</wicri:regionArea>
<wicri:noRegion>Ontario</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
<idno type="ISSN">0885-3185</idno>
<idno type="eISSN">1531-8257</idno>
<imprint><date when="2013">2013</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Aged</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Mental Status Schedule</term>
<term>Middle Aged</term>
<term>Mild Cognitive Impairment (diagnosis)</term>
<term>Mild Cognitive Impairment (etiology)</term>
<term>Neuropsychological Tests</term>
<term>Parkinson Disease (complications)</term>
<term>ROC Curve</term>
<term>Retrospective Studies</term>
</keywords>
<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnosis" xml:lang="en"><term>Mild Cognitive Impairment</term>
</keywords>
<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Mild Cognitive Impairment</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Aged</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Mental Status Schedule</term>
<term>Middle Aged</term>
<term>Neuropsychological Tests</term>
<term>ROC Curve</term>
<term>Retrospective Studies</term>
</keywords>
</textClass>
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</teiHeader>
<front><div type="abstract" xml:lang="en"><p id="P1">We examined the frequency of Parkinson disease with mild cognitive impairment (PD-MCI) and its subtypes and the accuracy of 3 cognitive scales for detecting PD-MCI using the new criteria for PD-MCI proposed by the Movement Disorders Society. Nondemented patients with Parkinson’s disease completed a clinical visit with the 3 screening tests followed 1 to 3 weeks later by neuropsychological testing. Of 139 patients, 46 met Level 2 Task Force criteria for PD-MCI when impaired performance was based on comparisons with normative scores. Forty-two patients (93%) had multi-domain MCI. At the lowest cutoff levels that provided at least 80% sensitivity, specificity was 44% for the Montreal Cognitive Assessment and 33% for the Scales for Outcomes in Parkinson’s Disease-Cognition. The Mini-Mental State Examination could not achieve 80% sensitivity at any cutoff score. At the highest cutoff levels that provided specificity of at least 80%, sensitivities were low (≤44%) for all tests. When decline from estimated premorbid levels was considered evidence of cognitive impairment, 110 of 139 patients were classified with PD-MCI, and 103 (94%) had multi-domain MCI. We observed dramatic differences in the proportion of patients who had PD-MCI using the new Level 2 criteria, depending on whether or not decline from premorbid level of intellectual function was considered. Recommendations for methods of operationalizing decline from premorbid levels constitute an unmet need. Among the 3 screening tests examined, none of the instruments provided good combined sensitivity and specificity for PD-MCI. Other tests recommended by the Task Force Level 1 criteria may represent better choices, and these should be the subject of future research.</p>
</div>
</front>
</TEI>
</record>
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