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. 2020 Sep;35(9):1618-1625.
doi: 10.1002/mds.28115. Epub 2020 Jun 10.

Subjective Cognitive Complaint in Parkinson's Disease Patients With Normal Cognition: Canary in the Coal Mine?

Rachael Purri  1 , Laura Brennan  2 , Jacqueline Rick  1 , Sharon X Xie  3 , Benjamin L Deck  4 , Lana M Chahine  5 , Nabila Dahodwala  1 , Alice Chen-Plotkin  1 , John E Duda  1   6 , James F Morley  1   6 , Rizwan S Akhtar  1 , John Q Trojanowski  7 , Andrew Siderowf  1 , Daniel Weintraub  1   6   8
Affiliations

Subjective Cognitive Complaint in Parkinson's Disease Patients With Normal Cognition: Canary in the Coal Mine?

Rachael Purri et al. Mov Disord. 2020 Sep.

Abstract

Objective: The objective of this study was to determine the frequency and impact of subjective cognitive complaint (SCC) in Parkinson's disease (PD) patients with normal cognition.

Methods: Patients with PD with expert consensus-determined normal cognition at baseline were asked a single question regarding the presence of SCC. Baseline (N = 153) and longitudinal (up to 4 follow-up visits during a 5-year period; N = 121) between-group differences in patients with PD with (+SCC) and without (-SCC) cognitive complaint were examined, including cognitive test performance and self-rated and informant-rated functional abilities.

Results: A total of 81 (53%) participants reported a cognitive complaint. There were no between-group differences in global cognition at baseline. Longitudinally, the +SCC group declined more than the -SCC group on global cognition (Mattis Dementia Rating Scale-2 total score, F1,431 = 5.71, P = 0.02), processing speed (Symbol Digit Modalities Test, F1,425 = 7.52, P = 0.006), and executive function (Trail Making Test Part B, F1,419 = 4.48, P = 0.04), although the results were not significant after correction for multiple testing. In addition, the +SCC group was more likely to progress to a diagnosis of cognitive impairment over time (hazard ratio = 2.61, P = 0.02). The +SCC group also demonstrated significantly lower self-reported and knowledgeable informant-reported cognition-related functional abilities at baseline, and declined more on an assessment of global functional abilities longitudinally.

Conclusions: Patients with PD with normal cognition, but with SCC, report poorer cognition-specific functional abilities, and are more likely to be diagnosed with cognitive impairment and experience global functional ability decline long term. These findings suggest that SCC and worse cognition-related functional abilities may be sensitive indicators of initial cognitive decline in PD. © 2020 International Parkinson and Movement Disorder Society.

Keywords: Parkinson disease; cognition; cognitive complaints.

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Figures

Figure 1.
Figure 1.
Cognitive Complaint in PD Patients
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