Objective: The overall goal of this study was to learn whether clinician ratings of cognition would predict trajectory of changes in memory performance over a 5-year period in newly diagnosed individuals with Parkinson’s disease (PD).

Background: Current methods for defining PD-mild cognitive impairment require self-reported cognitive concerns, in ideal situations, verified by a secondary source. The bulk of the existing literature has focused on the relationship between self-reported subjective and objective cognitive performance and yielded mixed findings. To date, the prognostic utility of clinician-rated subjective and objective cognitive decline using a well-validated measure remains elusive.

Method: A secondary data analysis of the Parkinson’s Progression Markers Initiative (PPMI) included 430 newly diagnosed patients with PD who were followed for up to five years. Memory was assessed using the Hopkins-Verbal Learning Test Retention Index (HVLT-R). Clinician rating for cognitive status was assessed using item 1 from the Unified Parkinson’s disease Rating Scale (UPDRS) Part I. Clinician ratings were dichotomized as CC+ (range = 1 to 2) or CC- (score of 0). Motor severity was assessed using the UPDRS Part III, depression using the Geriatric Depression Scale-15, and working memory using Letter-Number-Sequencing. Multilevel models (MLM) examined the longitudinal relationship between clinician ratings of cognition and memory performance.

Results: Clinician ratings of cognition at baseline were associated with worse scores on an objective HVLT-R memory index (b=-4.60, p<.01).  Moreover, those with worse working memory performance had worse average memory ability (b=-1.40, p<.001) and declined at a faster rate from occasion-to-occasion (b=-0.46, p<.01). Mood and motor severity did not explain individual differences or trajectories of change in memory performance.

Conclusion: Clinician ratings of cognition, as measured by the UPDRS Part I, are sensitive to declines in cognitive performance in de novo patients with PD. Future work should examine the diagnostic power of the UPDRS Part I in the evaluation of Parkinson’s disease mild cognitive impairment and/or dementia.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/clinician-ratings-of-cognition-predict-trajectory-of-cognitive-decline-in-newly-diagnosed-individuals-with-parkinsons-disease/