Objective: This systematic review aimed to synthesise current neuropsychological predictors of cognitive decline in Parkinson’s disease (PD).

Background: The observed heterogeneity of cognitive function in PD may be attributed to the variability in measures used to assess cognition from clinic to clinic. To propose recommendations for a PD-specific cognitive toolkit, we evaluated the predictive utility of neuropsychological measures to predict cognitive decline in PD.

Method: Systematic literature searches were performed in PubMed, SCOPUS, Medline, PyscINFO and CINAHL databases with terms related to ‘longitudinal’, ‘predictor’, ‘cognitive decline’, ‘dementia’, and ‘PD’. Articles published up to July 2023 were screened by two independent reviewers, following PRISMA guidelines. Quality was assessed using the Newcastle-Ottawa scale for individual studies and the GRADE system for each cognitive outcome.

Results: Twenty-eight articles with low to moderate risk of bias were included. The highest grade of evidence was produced for category verbal fluency, Trail-making A, Symbol Digit Modalities Test, measures of immediate verbal memory, and the Montreal Cognitive Assessment, supporting their utility in PD. Low quality evidence supporting use of the Trail-making B, Stroop test, Letter Number Sequencing, pentagon copying, and measures of delayed verbal and visual memory in PD was produced. Consistent evidence against the predictive utility of letter fluency and digit span measures was produced, and eight other measures produced very low quality of evidence due to insufficient studies / mixed results.

Conclusion: Our critical summary of the evidence base for key neuropsychological predictors of cognitive decline in PD will ultimately be used to inform evidence-based clinical practice guidelines for the evaluation and diagnosis of cognitive impairment in PD (PDCogniCare).

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MDS Abstracts - https://www.mdsabstracts.org/abstract/neuropsychological-predictors-of-cognitive-decline-in-parkinsons-disease-a-systematic-review-pdcognicare/