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

ICICLE-PD study group; Rachael A Lawson; Alison J Yarnall; Gordon W Duncan; David P Breen; Tien K Khoo; Caroline H Williams-Gray; Roger A Barker; David J Burn

doi:10.1136/jnnp-2016-315099

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

ICICLE-PD study group, Rachael A Lawson, Alison J Yarnall, Gordon W Duncan, David P Breen, Tien K Khoo, Caroline H Williams-Gray, Roger A Barker, David J Burn

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

Abstract / Description of output

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
Journal	Journal of Neurology, Neurosurgery & Psychiatry
DOIs	https://doi.org/10.1136/jnnp-2016-315099
Publication status	Published - 1 Mar 2017

Keywords / Materials (for Non-textual outputs)

Journal Article

Access to Document

10.1136/jnnp-2016-315099

648.full
This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY 4.0) license, which permits others to distribute, remix, adapt and build upon this work, for commercial use, provided the original work is properly cited. See: http://creativecommons.org/licenses/by/4.0/
Final published version, 812 KBLicence: Creative Commons: Attribution (CC-BY)

Cite this

@article{505194fb0c5d43db844decc5cfe27852,

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

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.",

keywords = "Journal Article",

author = "{ICICLE-PD study group} and 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}",

note = "Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.",

year = "2017",

month = mar,

day = "1",

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

language = "English",

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

issn = "0022-3050",

publisher = "BMJ Publishing Group",

}

TY - JOUR

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

AU - ICICLE-PD study group

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

N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.

PY - 2017/3/1

Y1 - 2017/3/1

N2 - 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.

AB - 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.

KW - Journal Article

U2 - 10.1136/jnnp-2016-315099

DO - 10.1136/jnnp-2016-315099

M3 - Article

C2 - 28250029

SN - 0022-3050

JO - Journal of Neurology, Neurosurgery & Psychiatry

JF - Journal of Neurology, Neurosurgery & Psychiatry

ER -

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

Abstract / Description of output

Keywords / Materials (for Non-textual outputs)

Access to Document

Fingerprint

Cite this