Parkinson’s Disease-Cognitive Rating Scale for Evaluating Cognitive Impairment in Parkinson’s Disease: A Systematic Review

Abstract

The aim of the present systematic review was to examine the evidence on the accuracy and psychometric properties of the Parkinson’s Disease-Cognitive Rating Scale (PD-CRS) for evaluating the presence of cognitive impairment in patients with Parkinson’s disease (PD) as well as to highlight the quality and quantity of research available on the use of the PD-CRS in this population. We searched four databases from inception until July 2020. Eight studies, published between 2008 and 2020, met the inclusion criteria: One cross-sectional study in which participants were assessed with the index test (PD-CRS) and a reference standard diagnostic assessment, in accordance with the Level II criteria of the International Parkinson and Movement Disorder Society (MDS); one case-control study comparing the PD-CRS to an extensive battery of tests (i.e., MDS Level II diagnosis); and six studies comparing the PD-CRS to other short cognitive batteries. In patients with Parkinson’s disease, the PD-CRS test provides information about cortical and sub-cortical cognitive functions. Even if it demonstrated good psychometric properties, the results regarding the optimal threshold for detecting mild cognitive impairment and dementia in PD are somewhat inconsistent. Further cross-sectional studies are necessary to examine the optimum cut-off score for detecting cognitive dysfunction in PD patients.

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“…However, the currently published suggestions for PDD cut-offs are rather inconsistent themselves. 23 In our study, all patients had Parkinson’s disease CRS scores below 73.5/134, which meets the cut-off proposed most recently. 23 Scores are also influenced by educational and socioeconomic parameters.…”

“… 23 In our study, all patients had Parkinson’s disease CRS scores below 73.5/134, which meets the cut-off proposed most recently. 23 Scores are also influenced by educational and socioeconomic parameters. To avoid incorrectly excluding patients, we decided to take a more liberal threshold for this scale (= 81), and cite a review article that discusses these figures in depth.…”

“…To avoid incorrectly excluding patients, we decided to take a more liberal threshold for this scale (= 81), and cite a review article that discusses these figures in depth. 23 We acknowledge that some of our recruited patients may demonstrate scores similar to patients with mild cognitive impairment features and consider this a methodological limitation.…”

“…Read more about this approach elsewhere. 23 Neuropsychiatric symptoms were assessed using the Neuropsychiatric Inventory (NPI). 24 All patients were assessed clinically in the ‘off’ medication state.…”

Psychometric properties and construct validity of the Parkinson’s Disease-Cognitive Rating Scale (PD-CRS) in Colombia

“…In consequence, level 1 scales, such as PD-CRS become relevant in daily practice. PD-CRS is an instrument that was specifically designed for PD cognitive evaluation and assesses cortical and subcortical functions ( Pagonabarraga et al, 2008 ) which have been widely studied in diverse populations ( Pagonabarraga et al, 2008 ; Martínez Martín et al, 2009 ; Fernández de Bobadilla et al, 2013 ; Santangelo et al, 2014 ; Fernández-Bobadilla et al, 2017 ; Samat et al, 2017 ; Serrano-Dueñas et al, 2017 ; Koevoets et al, 2018 ; Tan et al, 2020 ; Mahmoudi Asl et al, 2022 ); unfortunately, studies assessing this instrument’s consistency are heterogeneous in terms of patients’ clinical and sociodemographic characteristics ( Rosca and Simu, 2020 ) and only one study has been carried out on Latin American population ( Serrano-Dueñas et al, 2017 ).…”