Assessing the utility of the Movement Disorder Society Task Force Level 1 diagnostic criteria for mild cognitive impairment in Parkinson's disease

作者：Szeto Jennifer Y Y; Mowszowski Loren; Gilat Moran; Walton Courtney C; Naismith Sharon L; Lewis Simon J G^*

来源：Parkinsonism & Related Disorders, 2015, 21(1): 31-35.

DOI：10.1016/j.parkreldis.2014.10.020

• Mild cognitive impairment
• Parkinson's disease
• Cognitive decline
• Neuropsychological tests

Background: Using the Movement Disorder Society (MDS) Task Force Level 1 criteria, this study examined the classification of mild cognitive impairment in Parkinson's Disease (PD-MCI) derived from a range of cut-off scores that have previously been suggested by the MDS Task Force. Furthermore, differences in PD-MCI frequencies were examined when comparing performance on current neuropsychological testing to the normative sample, as opposed to decline from premorbid functioning, as evidence of cognitive impairment.
Method: Two hundred and thirty-four non-demented PD patients underwent neurological and neuropsychological assessment at the Parkinson's Disease Research Clinic at the Brain and Mind Research Institute, University of Sydney.
Results: When cognitive impairment was defined as 1SD and 1.5SD below premorbid intellect, 109 patients (47%) and 76 (32%) patients met criteria for PD-MCI respectively. This proportion dropped considerably to 50 patients (21%) with a 2SD cut-off score. However, when calculating impairment based on comparisons with normative data, only 68 patients (29%) and 41 patients (18%) met PD-MCI criteria when a cut-off score of 1 and 1.5SD was employed. This proportion dropped to just 22 patients (9%) with a 2SD cut-off score.
Conclusion: Results from the present study suggest that the MDS PD-MCI criteria may be too broad, as substantial differences in frequencies of PD-MCI were observed with the application of differing criteria. We propose that a 1.5SD cut-off score below premorbid functioning may provide greater utility in characterizing PD-MCI than a 1.5SD cut-off below normative data, which has been widely applied in previous studies examining the MDS PD-MCI criteria.

• 出版日期2015-1