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  • Which Neuropsychological Tests? Predicting Cognitive Decline and Dementia in Parkinson's Disease in the ICICLE-PD Cohort

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    Khoo496867-Accepted.pdf (653.4Kb)
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    Accepted Manuscript (AM)
    Author(s)
    Lawson, Rachael A
    Williams-Gray, Caroline H
    Camacho, Marta
    Duncan, Gordon W
    Khoo, Tien K
    Breen, David P
    Barker, Roger A
    Rochester, Lynn
    Burn, David J
    Yarnall, Alison J
    ICICLE-PD study group
    Griffith University Author(s)
    Khoo, Tien Kheng
    Year published
    2021
    Metadata
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    Abstract
    BACKGROUND: Cognitive impairment is common in Parkinson's disease (PD), with 80% cumulatively developing dementia (PDD). OBJECTIVE: We sought to identify tests that are sensitive to change over time above normal ageing so as to refine the neuropsychological tests predictive of PDD. METHODS: Participants with newly diagnosed PD (n = 211) and age-matched controls (n = 99) completed a range of clinical and neuropsychological tests as part of the ICICLE-PD study at 18-month intervals over 72 months. Impairments on tests were determined using control means (<1-2SD) and median scores. Mild cognitive impairment (PD-MCI) was classified ...
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    BACKGROUND: Cognitive impairment is common in Parkinson's disease (PD), with 80% cumulatively developing dementia (PDD). OBJECTIVE: We sought to identify tests that are sensitive to change over time above normal ageing so as to refine the neuropsychological tests predictive of PDD. METHODS: Participants with newly diagnosed PD (n = 211) and age-matched controls (n = 99) completed a range of clinical and neuropsychological tests as part of the ICICLE-PD study at 18-month intervals over 72 months. Impairments on tests were determined using control means (<1-2SD) and median scores. Mild cognitive impairment (PD-MCI) was classified using 1-2SD below normative values. Linear mixed effects modelling assessed cognitive decline, while Cox regression identified baseline predictors of PDD. RESULTS: At 72 months, 46 (cumulative probability 33.9%) participants had developed PDD; these participants declined at a faster rate in tests of global cognition, verbal fluency, memory and attention (p <  0.05) compared to those who remained dementia-free. Impaired baseline global cognition, visual memory and attention using median cut-offs were the best predictors of early PDD (area under the curve [AUC] = 0.88, p <  0.001) compared to control-generated cut-offs (AUC = 0.76-0.84,p <  0.001) and PD-MCI (AUC] = 0.64-0.81, p <  0.001). Impaired global cognition and semantic fluency were the most useful brief tests employable in a clinical setting (AUC = 0.79, p <  0.001). CONCLUSION: Verbal fluency, attention and memory were sensitive to change in early PDD and may be suitable tests to measure therapeutic response in future interventions. Impaired global cognition, attention and visual memory were the most accurate predictors for developing a PDD. Future studies could consider adopting these tests for patient clinical trial stratification.
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    Journal Title
    Journal of Parkinson's Disease
    DOI
    https://doi.org/10.3233/JPD-212581
    Copyright Statement
    © 2021 IOS Press. This is the author-manuscript version of this paper. Reproduced in accordance with the copyright policy of the publisher. Please refer to the journal website for access to the definitive, published version.
    Subject
    Biochemistry and cell biology
    Neurosciences
    Parkinson’s disease
    cognitive dysfunction
    neurocognitive disorders
    neuropsychological tests
    Publication URI
    http://hdl.handle.net/10072/404989
    Collection
    • Journal articles

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