Objective: To investigate the association between cognitive function at baseline and the progression of motor disability in Parkinson’s disease (PD).

Background: There is increasing clinical evidence to support the potential associations between cognitive dysfunction and motor disability in patients with PD, which may indicate common or parallel underlying pathological processes.

Method: We consecutively enrolled 257 drug-naïve patients with early-stage PD (follow-up > 2 years) who underwent a detailed neuropsychological test at initial assessment. Factor analysis was conducted to yield four cognitive function factors and their composite scores: Factor 1 (visual memory/visuospatial), Factor 2 (verbal memory), Factor 3 (frontal/executive), and Factor 4 (attention/working memory/language). The global cognitive composite score of each patient was calculated based on these factors. Subsequently, we assessed the effect of baseline cognitive function on long-term motor outcomes, namely levodopa-induced dyskinesia (LID), wearing-off, freezing of gait (FOG), and rate of longitudinal increases in levodopa-equivalent dose (LED).

Results: Cox regression analysis demonstrated that higher Factor 3 (frontal/executive) composite scores (i.e., better cognitive performance) were associated with early development of LID (hazard ratio [HR], 1.415; p = 0.010), whereas higher Factor 1 (visual memory/visuospatial) composite scores were associated with a lower risk for FOG (HR, 0.698; p = 0.020). We found a trend that higher global cognitive composite scores were associated with a lower risk for developing FOG (HR, 0.513; p = 0.076). The linear mixed model demonstrated that higher global cognitive composite scores and better cognitive performance in visual memory/visuospatial function were associated with slower longitudinal increases in LED.

Conclusion: These findings suggest that baseline cognitive profiles have prognostic implications on several motor aspects in patients with PD.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/baseline-cognitive-profile-is-closely-associated-with-long-term-motor-prognosis-in-newly-diagnosed-parkinsons-disease/