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Review
. 2022 Mar;32(1):149-160.
doi: 10.1007/s11065-021-09502-7. Epub 2021 Apr 16.

Meta-Analysis of Cognition in Parkinson's Disease Mild Cognitive Impairment and Dementia Progression

Elizabeth R Wallace  1 , Suzanne C Segerstrom  2 , Craig G van Horne  3   4 , Frederick A Schmitt  2   3 , Lisa M Koehl  5
Affiliations
Review

Meta-Analysis of Cognition in Parkinson's Disease Mild Cognitive Impairment and Dementia Progression

Elizabeth R Wallace et al. Neuropsychol Rev. 2022 Mar.

Abstract

Mild cognitive changes, including executive dysfunction, are seen in Parkinson's Disease (PD). Approximately 30% of individuals with PD develop Parkinson's disease dementia (PDD). Mild cognitive impairment (MCI) has been identified as a transitional state between normal cognition and dementia. Although PD-MCI and its cognitive correlates have been increasingly studied as a risk indicator for development of PDD, investigations into the PD-MCI construct have yielded heterogeneous findings. Thus, a typical PD-MCI cognitive profile remains undefined. The present meta-analysis examined published cross-sectional studies of PD-MCI and cognitively normal PD (PD-CN) groups to provide aggregated effect sizes of group test performance by cognitive domain. Subsequently, longitudinal studies examining PD-MCI to PDD progression were meta-analyzed. Ninety-two cross-sectional articles of PD-MCI vs. PD-CN were included; 5 longitudinal studies of PD-MCI conversion to PDD were included. Random effects meta-analytic models were constructed resulting in effect sizes (Hedges' g) for cognitive domains. Overall performance across all measures produced a large effect size (g = 0.83, 95% CI [0.79, 0.86], t2 = 0.18) in cross-sectional analyses, with cognitive screeners producing the largest effect (g = 1.09, 95% CI [1.00, 1.17], t2 = 0.19). Longitudinally, overall measures produced a moderate effect (g = 0.47, 95% CI [0.40, 0.53], t2 = 0.01), with measures of executive functioning exhibiting the largest effect (g = 0.70, 95% CI [0.51, 0.89], t2 = 0.01). Longitudinal effects were made more robust by low heterogeneity. This report provides the first comprehensive meta-analysis of PD-MCI cognitive outcomes and predictors in PD-MCI conversion to PDD. Limitations include heterogeneity of cross-sectional effect sizes and the potential impact of small-study effects. Areas for continued research include visuospatial skills and visual memory in PD-MCI and longitudinal examination of executive dysfunction in PD-MCI.

Keywords: Cognition; Dementia; Mild cognitive impairment; Parkinson’s disease.

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References

    1. Aarsland, D., Andersen, K., Larsen, J. P., & Lolk, A. (2003). Prevalence and characteristics of dementia in Parkinson disease: An 8-year prospective study. Archives of Neurology, 60(3), 387–392.
    1. Aarsland, D., Brønnick, K., Williams-Gray, C., Weintraub, D., Marder, K., Kulisevsky, J., & Santangelo, G. (2010). Mild cognitive impairment in Parkinson disease: A multicenter pooled analysis. Neurology, 75(12), 1062–1069. - PubMed - PMC
    1. Aarsland, D., Creese, B., Politis, M., Chaudhuri, K. R., Weintraub, D., & Ballard, C. (2017). Cognitive decline in Parkinson disease. Nature Reviews Neurology, 13(4), 217. - PubMed - PMC
    1. Agosta, F., Canu, E., Stefanova, E., Sarro, L., Tomić, A., Špica, V., & Filippi, M. (2014). Mild cognitive impairment in Parkinson’s disease is associated with a distributed pattern of brain white matter damage. Human Brain Mapping, 35(5), 1921–1929. - PubMed
    1. Akhtar, R. S., Xie, S. X., Chen, Y. J., Rick, J., Gross, R. G., Nasrallah, I. M., & Siderowf, A. D. (2017). Regional brain amyloid-β accumulation associates with domain-specific cognitive performance in Parkinson disease without dementia. PLoS One, 12(5), e0177924. - PubMed - PMC

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