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P1‐197: Detection of mild cognitive impairment in idiopathic Parkinson's disease with the mattis dementia rating scale
Author(s) -
Matteau Evelyne,
Dupre Nicolas,
Simard Martine
Publication year - 2008
Publication title -
alzheimer's and dementia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 6.713
H-Index - 118
eISSN - 1552-5279
pISSN - 1552-5260
DOI - 10.1016/j.jalz.2008.05.785
Subject(s) - dementia , neuropsychology , rating scale , cognitive impairment , psychology , cognition , clinical dementia rating , parkinson's disease , audiology , medicine , disease , psychiatry , developmental psychology
Background: A state of Mild Cognitive Impairment, that would be analogous to the preclinical phase of Alzheimer’s disease, can be found in idiopathic Parkinson’s Disease (PD-MCI). Given that therapeutic agents for treating PD’s cognitive decline seem more efficacious if administered early, detection of MCI in PD is of great interest. Objective: This study aimed at exploring the sensitivity of the Mattis Dementia Rating Scale (MDRS) to detect the presence of MCI in PD. Methods: Sixteen patients with PD-MCI and 29 healthy controls (HC) matched according to age, education and gender were identified from an on-going clinical study. PD patients underwent comprehensive neurological and neuropsychological evaluations. Diagnoses of MCI were made if individuals presented an impaired performance (i.e. 1.5 SD below the mean of normative data) on at least one of the five cognitive domains assessed. Cognitive deficits should not have caused functional impairments (Petersen, 1999; 2001). Ageand education-corrected scaled scores for the MDRS-total and agecorrected scaled scores for each MDRS-subscale were converted into Z scores and compared between groups. Results: The distribution of the PD-MCI’s subtypes was as follows: non-memory-single domain 50%, non-memorymultiple domains 25%, memorymultiple domains 19% and memory-single domain 6%. PD patients received their diagnosis when aged 58.7 10.6 years, and their disease duration was approximately of 9.5 5 years. PD-MCI patients scored significantly lower than HC on the MDRS-Total (PD-MCI -0.21 0.81; HC 0.38 0.63; p .01, d .82) and on Initiation/Perseveration subscale (PDMCI -0.46 0./81; HC 0.44 0.52; p .015, d 1.35). Finally, a ROC analysis established that the optimal MDRStotal cutoff score to properly screen MCI in PD is 140/144 (sensitivity 81.3%, specificity 41%, AUC .71, LR 1.39). Conclusions: The results of the present study validate the utilization of the MDRS as a cognitive screening test to identify PD patients with MCI, who are eventually at risk to develop dementia. Our findings that frontal / executive dysfunction is the most problematic cognitive domain in PD-MCI are congruent with the results of previous research.