Objective: To assess the prevalence of subjective cognitive decline (SCD) and to look for its association with frailty in an Asian cohort of patients with Parkinson’s Disease (PD).

Background: The concept of subjective cognitive decline has gained a growing interest due to its role in early detection of cognitive impairment in patients with Parkinson’s Disease as well as a possible role in early prediction of progression to dementia[1,2]. Frailty is also a geriatric syndrome that is highly prevalent among PD patients and is often associated with increased morbidity and mortality[3].

Method: A total of 86 patients were recruited from an integrated Parkinson’s clinic. All patients were more than 65 years old. Patients with cognitive concerns and an MMSE >24 were identified to have subjective cognitive decline. Clinical Frailty Scale was used to assess their frailty status and a modified Barthel Index was used to assess their functional status. Charlson Comorbidity Index was calculated to assess the burden of comorbidities.

Results: The cohort of 86 patients had a mean age of 75.73±6.65 years and were predominantly of Chinese ethnicity (91.8%). There were 50 males (58.13%) and 36 females (41.86%). 52 (60.46%) had a Charlson Comorbidity Index >3 which indicates a 10-year survival of >54%. Mean MBI was 81.65±27.98 with 82.5% (71) having an MBI>60. SCD was noted in 20.93% (18)patients in the cohort with a mean MMSE of 24.07±6.53. Prevalence of frailty was noted to be 81.39% with 51.16%(44) being mildly frail, 20.93%(18) moderately frail and 9.3%(8) severely frail. A negative Pearson correlation coefficient of 0.62 (p=0.008) was noted between subjective cognitive decline and frailty.

Conclusion: SCD is increasingly being detected in patients with PD. The presence of concomitant frailty can negatively influence clinical outcomes and lead to more complications as the disease progresses. Our results show a strong correlation between the presence of SCD and frailty in patients with PD. Further research is needed to elaborate on the clinical implications of this association and its effect on morbidity, mortality and quality of life.

References: 1. Oedekoven C, Egeri L, Jessen F, Wagner M, Dodel R. Subjective cognitive decline in idiopathic Parkinson´s disease: A systematic review. Ageing Res Rev. 2022 Feb;74:101508. doi: 10.1016/j.arr.2021.101508. Epub 2021 Nov 3. PMID: 34740867.
2. Aarsland D, Batzu L, Halliday GM, Geurtsen GJ, Ballard C, Ray Chaudhuri K, Weintraub D. Parkinson disease-associated cognitive impairment. Nat Rev Dis Primers. 2021 Jul 1;7(1):47. doi: 10.1038/s41572-021-00280-3. Erratum in: Nat Rev Dis Primers. 2021 Jul 13;7(1):53. PMID: 34210995.
3. McMillan JM, Michalchuk Q, Goodarzi Z. Frailty in Parkinson’s disease: A systematic review and meta-analysis. Clin Park Relat Disord. 2021 May 25;4:100095. doi: 10.1016/j.prdoa.2021.100095. PMID: 34316672; PMCID: PMC8299963.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/subjective-cognitive-decline-and-frailty-in-an-asian-cohort-of-patients-with-parkinsons-disease/