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Cognitive Complaints in Nondemented Parkinson’s Disease Patients and Their Close Contacts do not Predict Worse Cognitive Outcome

AlDakheel, Amaal, MD*,†; Gasca-Salas, Carmen, MD, PhD*,‡; Armstrong, Melissa J., MSc, MD§; Duff-Canning, Sarah, PhD, C Psych; Marras, Connie, MD, PhD*

Alzheimer Disease & Associated Disorders: April-June 2019 - Volume 33 - Issue 2 - p 147–153
doi: 10.1097/WAD.0000000000000301
Original Articles
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Objectives: The main purpose of this study was to investigate 4 methods of eliciting subjective cognitive complaints (SCCs) in Parkinson’s disease (PD) patients without dementia and determine the relationship between their SCC and cognitive performance.

Design: This study was a retrospective analysis of a prospective cohort study.

Setting: Six North American movement disorder clinics.

Measurements: SCCs were elicited through a modified Neurobehavioral Inventory administered to patients and close contacts, a general complaint question, and Movement Disorders Society Unified Parkinson's Disease Rating Scale item question 1.1 administered to patients. Clinical evaluation, formal neuropsychological testing and Disability Assessment for Dementia were conducted in Ontario state. Agreement between SCCs eliciting methods was calculated. Associations between SCC, cognitive testing, and mild cognitive impairment (MCI) were assessed.

Results: Of 139 participating nondemented PD patients, 42% had PD-MCI at baseline. Agreement between SCC eliciting methods was low. Neither patient-reported nor close contact-reported SCCs were associated with impaired baseline cognitive testing or PD-MCI nor were they associated with cognitive decline over time. In PD patients with normal baseline cognition, 26% of patients with 1-year follow-up and 20% of patients with 2-year follow-up met MCI criteria.

Conclusions: Agreement between SCC eliciting methods is poor and no SCC method was associated with cognitive testing or decline over time. With no clear superior method for eliciting SCCs, clinicians should consider performing regular screening.

*Division of Neurology, Morton and Gloria Shulman Movement Disorders Center and the Edmond J Safra Program in Parkinson’s disease, Toronto Western Hospital, University of Toronto

Department of Neuropsychology, Toronto Western Hospital, UHN, University of Toronto, Toronto, ON, Canada

Department of Neurosciences, Division of Neurology, King Faisal Specialist Hospital & Research Center, Riyadh, Saudi Arabia

Centre for Integrative Neuroscience AC, HM Puetra del Sur, Madrid Hospital and Medical School, CEU San Pablo University, Madrid, Spain

§Department of Neurology, University of Maryland School of Medicine, Baltimore, MD

M.J.A. has received honoraria for serving as faculty at annual meetings of the American Academy of Neurology (2014, 2015, 2016) and the Movement Disorders Society (2013, 2014) and on the American Academy of Neurology curriculum EBM Online. She is currently funded by an AHRQ career development grant (K08HS24159-01). She received funding as a subinvestigator or local investigator on the NIH grants U01 AR057967-01, U01NS080818-01A1, and U01NS080840-01A1. She receives publishing royalties as a coauthor on Parkinson’s Disease: Improving Patient Care (Oxford University Press). She is an evidence-based medicine methodology consultant for the American Academy of Neurology. C.M. is employed for the University Health Network and has received Honoraria for teaching from EMD Serono. She received a grant from the Michael J Fox Foundation, Canadian Institutes of Health Research, National Parkinson Foundation, Parkinson Disease Foundation, and the Parkinson Society Canada. She is a site PI for clinical trial sponsored by the National Institutes of Health, Physician Services Incorporated. She has contract with Horizon Pharma. The remaining authors declare no conflicts of interest.

Reprints: Connie Marras, MD, PhD, Division of Neurology, Morton and Gloria Shulman Movement Disorders Center and the Edmond J Safra Program in Parkinson’s disease, Toronto Western Hospital, University of Toronto, McL-7, 399 Bathurst St., Toronto, ON, Canada M5T 2S8 (e-mail: connie.marras@utoronto.ca).

Received June 21, 2018

Accepted February 6, 2019

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