Stability of mild cognitive impairment in newly diagnosed Parkinson's disease

ICICLE-PD study group

doi:10.1136/jnnp-2016-315099

Stability of mild cognitive impairment in newly diagnosed Parkinson's disease

ICICLE-PD study group

Applied Medicine

Research output: Contribution to journal › Article › peer-review

52 Citations (Scopus)

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Abstract

Background
Mild cognitive impairment (MCI) is common in early Parkinson's disease (PD). We evaluated the stability of PD-MCI over time to determine its clinical utility as a marker of disease. Methods
212 newly diagnosed participants with PD were recruited into a longitudinal study and reassessed after 18 and 36 months. Participants completed a range of clinical and neuropsychological assessments. PD-MCI was classified using Movement Disorders Society Task Force level I (Montreal Cognitive Assessment <26) and level II (using cut-offs of 1, 1.5 and 2SD) criteria.
Results
After 36 months, 75% of participants returned; 8% of patients had developed a dementia all of which were previously PD-MCI. Applying level I criteria, 70% were cognitively stable, 19% cognitively declined and 11% improved over 36 months. Applying level II criteria (1, 1.5 and 2SD), 25% were cognitively stable, 41% cognitively declined, 15% improved and 19% fluctuated over 36 months. 18% of participants reverted to normal cognition from PD-MCI.
Discussion
Cognitive impairment in PD is complex, with some individuals' function fluctuating over time and some reverting to normal cognition. PD-MCI level I criteria may have greater clinical convenience, but more comprehensive level II criteria with 2SD cut-offs may offer greater diagnostic certainty.

Original language	English
Pages (from-to)	648-652
Number of pages	5
Journal	Journal of Neurology, Neurosurgery and Psychiatry
Volume	88
Issue number	8
Early online date	1 Mar 2017
DOIs	https://doi.org/10.1136/jnnp-2016-315099
Publication status	Published - 13 Jul 2017

Bibliographical note

This study was funded by Parkinson's UK (J-0802). The research was supported by the Lockhart Parkinson's Disease Research Fund, National Institute for Health Research (NIHR) Newcastle Biomedical Research Unit based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University and a NIHR Biomedical Research Centre award to the University of Cambridge/Cambridge University Hospitals NHS Trust.

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Lawson et al JNNP Stability of mild VOR
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Cite this

@article{7f45c2f70b3a40dcb8beb5d7539b9056,

title = "Stability of mild cognitive impairment in newly diagnosed Parkinson's disease",

abstract = "BackgroundMild cognitive impairment (MCI) is common in early Parkinson's disease (PD). We evaluated the stability of PD-MCI over time to determine its clinical utility as a marker of disease. Methods212 newly diagnosed participants with PD were recruited into a longitudinal study and reassessed after 18 and 36 months. Participants completed a range of clinical and neuropsychological assessments. PD-MCI was classified using Movement Disorders Society Task Force level I (Montreal Cognitive Assessment <26) and level II (using cut-offs of 1, 1.5 and 2SD) criteria. Results After 36 months, 75% of participants returned; 8% of patients had developed a dementia all of which were previously PD-MCI. Applying level I criteria, 70% were cognitively stable, 19% cognitively declined and 11% improved over 36 months. Applying level II criteria (1, 1.5 and 2SD), 25% were cognitively stable, 41% cognitively declined, 15% improved and 19% fluctuated over 36 months. 18% of participants reverted to normal cognition from PD-MCI. Discussion Cognitive impairment in PD is complex, with some individuals' function fluctuating over time and some reverting to normal cognition. PD-MCI level I criteria may have greater clinical convenience, but more comprehensive level II criteria with 2SD cut-offs may offer greater diagnostic certainty.",

author = "Lawson, {Rachael A.} and Yarnall, {Alison J.} and Duncan, {Gordon W.} and Breen, {David P.} and Khoo, {Tien K.} and Williams-Gray, {Caroline H.} and Barker, {Roger A.} and Burn, {David J.} and Lynn Rochester and Fionnuala Johnston and Claire McDonald and Isobel Sleeman and Chinnery, {Patrick F.} and O'Brien, {John T.} and Robbins, {Trevor W.} and Cummins, {Gemma A.} and Jonathan Evans and Brooks, {David J.} and Wesnes, {Keith A.} and Rowe, {James B.} and {ICICLE-PD study group}",

note = "This study was funded by Parkinson's UK (J-0802). The research was supported by the Lockhart Parkinson's Disease Research Fund, National Institute for Health Research (NIHR) Newcastle Biomedical Research Unit based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University and a NIHR Biomedical Research Centre award to the University of Cambridge/Cambridge University Hospitals NHS Trust.",

year = "2017",

month = jul,

day = "13",

doi = "10.1136/jnnp-2016-315099",

language = "English",

volume = "88",

pages = "648--652",

journal = "Journal of Neurology, Neurosurgery and Psychiatry",

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TY - JOUR

T1 - Stability of mild cognitive impairment in newly diagnosed Parkinson's disease

AU - Lawson, Rachael A.

AU - Yarnall, Alison J.

AU - Duncan, Gordon W.

AU - Breen, David P.

AU - Khoo, Tien K.

AU - Williams-Gray, Caroline H.

AU - Barker, Roger A.

AU - Burn, David J.

AU - Rochester, Lynn

AU - Johnston, Fionnuala

AU - McDonald, Claire

AU - Sleeman, Isobel

AU - Chinnery, Patrick F.

AU - O'Brien, John T.

AU - Robbins, Trevor W.

AU - Cummins, Gemma A.

AU - Evans, Jonathan

AU - Brooks, David J.

AU - Wesnes, Keith A.

AU - Rowe, James B.

AU - ICICLE-PD study group

N1 - This study was funded by Parkinson's UK (J-0802). The research was supported by the Lockhart Parkinson's Disease Research Fund, National Institute for Health Research (NIHR) Newcastle Biomedical Research Unit based at Newcastle upon Tyne Hospitals NHS Foundation Trust and Newcastle University and a NIHR Biomedical Research Centre award to the University of Cambridge/Cambridge University Hospitals NHS Trust.

PY - 2017/7/13

Y1 - 2017/7/13

N2 - BackgroundMild cognitive impairment (MCI) is common in early Parkinson's disease (PD). We evaluated the stability of PD-MCI over time to determine its clinical utility as a marker of disease. Methods212 newly diagnosed participants with PD were recruited into a longitudinal study and reassessed after 18 and 36 months. Participants completed a range of clinical and neuropsychological assessments. PD-MCI was classified using Movement Disorders Society Task Force level I (Montreal Cognitive Assessment <26) and level II (using cut-offs of 1, 1.5 and 2SD) criteria. Results After 36 months, 75% of participants returned; 8% of patients had developed a dementia all of which were previously PD-MCI. Applying level I criteria, 70% were cognitively stable, 19% cognitively declined and 11% improved over 36 months. Applying level II criteria (1, 1.5 and 2SD), 25% were cognitively stable, 41% cognitively declined, 15% improved and 19% fluctuated over 36 months. 18% of participants reverted to normal cognition from PD-MCI. Discussion Cognitive impairment in PD is complex, with some individuals' function fluctuating over time and some reverting to normal cognition. PD-MCI level I criteria may have greater clinical convenience, but more comprehensive level II criteria with 2SD cut-offs may offer greater diagnostic certainty.

AB - BackgroundMild cognitive impairment (MCI) is common in early Parkinson's disease (PD). We evaluated the stability of PD-MCI over time to determine its clinical utility as a marker of disease. Methods212 newly diagnosed participants with PD were recruited into a longitudinal study and reassessed after 18 and 36 months. Participants completed a range of clinical and neuropsychological assessments. PD-MCI was classified using Movement Disorders Society Task Force level I (Montreal Cognitive Assessment <26) and level II (using cut-offs of 1, 1.5 and 2SD) criteria. Results After 36 months, 75% of participants returned; 8% of patients had developed a dementia all of which were previously PD-MCI. Applying level I criteria, 70% were cognitively stable, 19% cognitively declined and 11% improved over 36 months. Applying level II criteria (1, 1.5 and 2SD), 25% were cognitively stable, 41% cognitively declined, 15% improved and 19% fluctuated over 36 months. 18% of participants reverted to normal cognition from PD-MCI. Discussion Cognitive impairment in PD is complex, with some individuals' function fluctuating over time and some reverting to normal cognition. PD-MCI level I criteria may have greater clinical convenience, but more comprehensive level II criteria with 2SD cut-offs may offer greater diagnostic certainty.

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U2 - 10.1136/jnnp-2016-315099

DO - 10.1136/jnnp-2016-315099

M3 - Article

C2 - 28250029

AN - SCOPUS:85024398283

SN - 0022-3050

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SP - 648

EP - 652

JO - Journal of Neurology, Neurosurgery and Psychiatry

JF - Journal of Neurology, Neurosurgery and Psychiatry

IS - 8

ER -

Stability of mild cognitive impairment in newly diagnosed Parkinson's disease

Abstract

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