Objective: To explore cognitive, neuropsychological and daily functional-related cognitive deficits among PD patients, diagnosed with mild cognitive impairment (MCI).

Background: Level I diagnostic criteria for PD-MCI includes an abbreviated global cognitive assessment, and Level II requires at least two neuropsychological tests that assess cognitive functioning in 5 domains. PD-MCI is defined when performance is 1 to 2 standard deviations below cut-off norms scores, or significantly decline from estimated premorbid levels. Knowledge about cognitive deficits in the context of daily functioning in this population is scarce.

Method: The study included 118 participants, ages 40-79, 77 diagnosed with PD who scored 22 to 25 on the global cognitive assessment Montreal Cognitive Assessment (MoCA). A control group included 41 healthy controls (HC) matched for gender, age, and education level, and scored >25 on the MoCA. All participants achieved <18 on the Beck Depression Inventory (BDI). Level II neuropsychological assessment tools were administered along with self-report questionnaires focused on participant's daily function abilities, such as the Time Organization and Participation Scale (TOPS).

Results: No significant group differences were found for gender, age or education level. Most participants education level in both groups was academic (PD: 60%; HC: 70%). Analysis revealed a surprisingly low number of participants in the PD-MCI group with cognitive deficit, according to the neuropsychological tests cut-off scores (0-56.4%). The highest rates were identified by the Trail Making Test A (PD: 56.4%; HC: 19.5%), B (PD: 38.5%; HC: 22.0%), and the Rey-Osterrieth Complex Figure Test (copying PD: 25.6%; HC: 4.9%; delayed recall (PD: 24.4%; HC: 12.2%). The profiles exhibited higher mean scores and a different distribution curve to the norm. The TOPS revealed significant differences between the groups indicating deficient ability in timely organization of daily activities and consequent emotional frustration for the PD subjects.

Conclusion: These results support the ongoing discussion of the complexity of capturing PD-MCI, particularly among people with premorbid high education level. Considering the neuropsychological tests results, assessments which reflect these people’s real-life daily confrontations are warranted.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/measuring-cognitive-decline-in-pd-mci-patients-with-high-level-education-do-we-have-the-appropriate-tools/