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Background In Parkinson’s disease, the association between objective and patient-reported measures of cognitive dysfunction is unknown and highly relevant to research and clinical care. Objective To determine which cognitive domain-specific Montreal Cognitive Assessment (MoCA) subscores are most strongly associated with patient-reported cognitive impairment on question 1 (Q1) of the Movement Disorders Society Unified Parkinson’s Disease Rating Scale (MDS-UPDRS). Methods We analyzed data from 759 PD participants and 481 persons without PD with in a retrospective, cross sectional analysis using data from the NINDS Parkinson’s Disease Biomarkers Program (PDBP), a longitudinal, multicenter biomarker study. The relationship between a patient-reported cognitive rating (MDS- UPDRS q1.1) and objective cognitive assessments (MoCA) was assessed using multinomial logistic regression modeling and the outcomes reported as conditional odds ratios (cOR’s) representing the relative odds of a participant reporting cognitive impairment that is “slight” versus “normal” on MDS-UPDRSq1.1 for a one unit increase in a MoCA sub-score, adjusted for age and education. Results In PD participants, changes in visuospatial-executive performance and memory had the most significant impact on subjective cognitive impairment. A 1-point increase in visuospatial-executive function decreased the chance of reporting a MDS-UPDRS Q1 score of “slight” versus “normal” by a factor of 0.686 (p<0.001) and each 1 point improvement in delayed recall decreased the odds of reporting “slight” cognitive impairment by a factor of 0.836 (p<0.001). Conclusions Conversion from a PD patient’s report of “normal” to “slight” cognitive impairment may be associated with changes in visuospatial-executive dysfunction and memory more than other cognitive domains.

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In 2 experiments, younger and older adults witnessed a simulated robbery, received misleading information about the event, and then were interviewed with the Cognitive Interview about their memory for the robbery. In both experiments, older adults were disproportionately more confident than younger adults in the accuracy of incorrect information that they recalled than in the accuracy of correct information. Critically, this age-related increase in high-confidence errors occurred even in comparison with younger adults who were matched with older adults on the overall amount and accuracy of the information remembered about the robbery. In addition, Experiment 2 showed that retrieval warnings to disregard the misinformation were just as effective in older adults as compared with younger adults at reducing the reporting of misleading information. Finally, both experiments showed that across the multiple retrieval stages of the Cognitive Interview, the final retrieval stage is roughly half as effective for older adults relative to younger adults at eliciting previously unreported information. These results indicate that investigators have much less to gain from older adults than they do from younger adults with repeated inquiries (during the same session) about a witnessed event.