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Evaluation of mild cognitive impairment subtypes in Parkinson's disease
Authors:Brenna A. Cholerton PhD  Cyrus P. Zabetian MD  MS  Jia Y. Wan MS  Thomas J. Montine MD  PhD  Joseph F. Quinn MD  Ignacio F. Mata PhD  Kathryn A. Chung MD  Amie Peterson MD  Alberto J. Espay MD  MSc  Fredy J. Revilla MD  Johnna Devoto PsyD  G. Stennis Watson PhD  Shu‐Ching Hu MD  PhD  James B. Leverenz MD  Karen L. Edwards PhD
Affiliation:1. Geriatric Research, Education, & Clinical Center, , Seattle, Washington, USA;2. Department of Psychiatry & Behavioral Science, University of Washington School of Medicine, , Seattle, Washington, USA;3. Parkinson's Disease Research, Education, & Clinical Center, , Seattle, Washington, USA;4. Department of Neurology, University of Washington School of Medicine, , Seattle, Washington, USA;5. Department of Epidemiology, University of Washington School of Medicine, , Seattle, Washington, USA;6. Department of Pathology, University of Washington School of Medicine, , Seattle, Washington, USA;7. Portland Veterans Affairs Medical Center, , Portland, Oregon, USA;8. Department of Neurology, Oregon Health and Science University, , Portland, Oregon, USA;9. Department of Neurology and Rehabilitation Medicine, University of Cincinnati, , Cincinnati, Ohio, USA;10. Cincinnati Veteran Affairs Medical Center, , Cincinnati, Ohio, USA;11. Mental Illness Research, Education, & Clinical Center Veterans Affairs Puget Sound Health Care System, , Seattle, Washington, USA
Abstract:
Mild cognitive impairment in Parkinson's disease (PD‐MCI) is common and increases the risk for dementia. Establishing distinct PD‐MCI cognitive subtypes could be valuable for eventually predicting those most likely to convert to dementia. However, the study of PD‐MCI subtypes has not yielded consistent results among cohorts. To determine whether there are distinct cognitive subtypes among participants diagnosed with PD‐MCI in the Pacific Northwest Udall Center Clinical Consortium, we cognitively subtyped 95 patients with PD‐MCI, using the Movement Disorders Society Task Force diagnostic guidelines. Psychometric test scores were then subjected to principle components factor analysis to determine whether similar cognitive subgroups could be identified using statistical methodology. Multiple‐domain PD‐MCI was diagnosed in 95% of the sample, and a range of cognitive impairments were noted. Factor analysis yielded seven factors and demonstrated overlap of phonemic verbal fluency on two factors, as well as the loading of verbal fluency on the same factor as a visuospatial measure; however, these factors did not partition the sample into distinct cognitive subtypes. Separation of cognitive subtypes based on the current PD‐MCI criteria, or via statistical methods, may not provide sufficient information to describe distinct PD groups. Future efforts to validate the PD‐MCI criteria and identify combinations of genetic or other risk factors for cognitive impairment are warranted. © 2014 International Parkinson and Movement Disorder Society
Keywords:Parkinson disease  cognition  mild cognitive impairment  neuropsychological assessment
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