Objective: To examine whether Parkinson’s disease (PD) patients with or without mild cognitive impairment (MCI) show impaired self-awareness (ISA) of their cognitive abilities.

Background: PD patients may show ISA of their cognitive deficits. For disease acceptance or understanding of cognitive capabilities, self-awareness of cognitive deficits is mandatory. Hence, we examined ISA of cognitive functions in PD patients with and without MCI.

Methods: Included were 55 PD patients and 15 age-matched controls. All participants received a cognitive assessment according to the MCI MDS-guidelines. For each patient/control, a relative was included who served as informant. Self- and proxy ratings were administered applying the cognitive failures questionnaire (CFQ) and the dysexecutive questionnaire (DEX). For both questionnaires, higher scores equal more impairment. The discrepancy between less impaired self-rating and more-impaired proxy-rating was considered as ISA. All patients and controls were compared concerning cognitive tests and questionnaires. Based on the cognitive test results, patients were divided into patients with (N=11) and without MCI (N=44). These were compared using the same questionnaires applying repeated measures ANOVA for self- vs. proxy-ratings.

Results: Patients were significantly more impaired than controls in cognitive tests. CFQ-scores were significantly higher in patients/controls compared to proxy ratings, while DEX-scores where comparable. Patients and their relatives rated significantly worse on the DEX than controls and their relatives. MCI and non-MCI patients did not differ concerning sex, age and disease duration. MCI-patients were significantly more impaired in cognitive tests than non-MCI patients. When self- and proxy-ratings were compared, MCI-relatives rated patients as more impaired than MCI-patients themselves on the CFQ and the DEX, therefore implying ISA. Non-MCI patients had higher self-ratings than proxy-ratings, therefore showing the opposite result. This interaction was significant for the CFQ, and nearly for the DEX.

Conclusions: Generally, patients and controls rate themselves worse in cognitive questionnaires than their relatives, therefore showing no signs of ISA. When PD patients with MCI are analyzed the results reverse and show more impaired proxy- than self-ratings. Hence, ISA of cognitive functions should be essentially analyzed in PD patients with MCI.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/self-awareness-of-cognitive-functions-in-parkinsons-disease-patients-with-and-without-mild-cognitive-impairment/