Cognitive complaints in Parkinson’s disease: its relationship with objective cognitive decline

Abstract

Cognitive complaint interviews (CCI) have been shown to be useful in the early detection of dementia in elderly people. Surprisingly, CCIs are rarely used in Parkinson's disease (PD), despite a six-fold higher risk of dementia than in healthy subjects. The present study sought to determine whether a structured CCI could detect cognitive decline in PD. A validated CCI was added to the usual clinical interview for 180 PD patients. Objective cognitive status was assessed by the Mattis dementia rating scale score. The CCIs ability to detect cognitive decline in PD patients was determined using a receiver operating characteristic (ROC) curve. 58 (32.22%) patients had a significant, subjective cognitive complaint (CCI score >3). Of these, 48.27% had objective cognitive decline. Objective cognitive decline was significantly more frequent in the patients with subjective cognitive complaint. However, the ROC curve for discriminating between patients with and without objective cognitive deficits as a function of their subjective cognitive complaint had low sensitivity (0.50, 95% CI: 0.36-0.64) and moderate specificity (0.74, 95% CI: 0.69-0.84). Logistic regression incorporating the main demographical and clinical variables showed that the CCI score's discriminant power was improved by adding age and the number of years in education to the predictive model. Objective cognitive decline and dementia are more frequent among PD patients reporting a cognitive complaint than among patients not reporting a complaint. However, the CCI does not enable more accurate screening for PD-associated dementia.

Presence or absence of cognitive complaints in Parkinson’s disease: mood disorder or anosognosia?

“…Identifying patients with higher risk of dementia at earlier stages could be an opportunity for further interventions 9 . In line with this, it has recently been shown that subjective cognitive complaints (SCC) may harbor early dementia 10,11 . On the other hand, it has been also found that cognitive complaints in the absence of dementia might be attributed to an underlying mood disorder 12 .…”

“…This may be due to the smaller number of patients with PD (n = 35) of their study. Dujardin et al 10 also found a greater rate of depressive symptoms in PD patients with cognitive complaints.…”

Subjective cognitive complaints and neuropsychological test performance following military-related traumatic brain injury

“…Problems with accuracy in selfreported cognitive symptoms are seen in a variety of health conditions, including cognitive functioning after cancer treatment [1], systemic lupus erythematosus [2], epilepsy [3], multiple sclerosis [4], Parkinson disease (PD) [5], and schizophrenia [6]. This reduced accuracy is generally related to overreporting of symptoms, but varies according to the condition.…”

Self-Reported Cognitive Decline on the Informant Questionnaire on Cognitive Decline in the Elderly Is Associated with Dementia, Instrumental Activities of Daily Living and Depression but Not Longitudinal Cognitive Change

“…Certainly, self-reported deficits appear to have poor validity in relation to current cognitive status [3,5,[16][17][18]. Studies that have examined cognitive change as a predictor of retrospective self-report have generally tracked change over 3-4 years across a single interval [4,[12][13][14][15]19].…”