Original research: initial development of a pragmatic tool to estimate cognitive decline risk focusing on potentially modifiable factors in Parkinson’s disease
IntroductionCognitive decline is common in Parkinson’s disease (PD). Calculating personalized risk of cognitive decline in PD would allow for appropriate counseling, early intervention with available treatments, and inclusion in disease-modifying trials.MethodsData were from the Parkinson’s Progress...
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| Format: | Article |
| Language: | English |
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Frontiers Media S.A.
2023-10-01
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| Series: | Frontiers in Neuroscience |
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fnins.2023.1278817/full |
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| author | Tara C. Carlisle Tara C. Carlisle Tara C. Carlisle Luis D. Medina Samantha K. Holden Samantha K. Holden Samantha K. Holden Samantha K. Holden |
| author_facet | Tara C. Carlisle Tara C. Carlisle Tara C. Carlisle Luis D. Medina Samantha K. Holden Samantha K. Holden Samantha K. Holden Samantha K. Holden |
| author_sort | Tara C. Carlisle |
| collection | DOAJ |
| description | IntroductionCognitive decline is common in Parkinson’s disease (PD). Calculating personalized risk of cognitive decline in PD would allow for appropriate counseling, early intervention with available treatments, and inclusion in disease-modifying trials.MethodsData were from the Parkinson’s Progression Markers Initiative de novo cohort. Baseline scores were calculated for Lifestyle for Brain Health (LIBRA) and the Montreal Parkinson Risk of Dementia Scale (MoPaRDS) per prior literature and preliminary Parkinson’s disease Risk Estimator for Decline In Cognition Tool (pPREDICT) by attributing a point for fourteen posited risk factors. Baseline and 5-year follow-up composite cognitive scores (CCSs) were calculated from a neuropsychological battery and used to define cognitive decliners (PD-decline) versus maintainers (PD-maintain).ResultsThe PD-decline group (n = 44) had higher LIBRA (6.76 ± 0.57, p < 0.05), MoPaRDS (2.45 ± 1.41, p < 0.05) and pPREDICT (4.52 ± 1.66, p < 0.05) scores compared to the PD-maintain group (n = 263; LIBRA 4.98 ± 0.20, MoPaRDS 1.68 ± 1.16, pPREDICT 3.38 ± 1.69). Area-under-the-curve (AUC) for LIBRA was 0.64 (95% confidence interval [CI], 0.55–0.73), MoPaRDS was 0.66 (95% CI, 0.58–0.75) and for pPREDICT was 0.68 (95% CI, 0.61–0.76). In linear regression analyses, LIBRA (p < 0.05), MoPaRDS (p < 0.05) and pPREDICT (p < 0.05) predicted change in CCS. Only age stratified by sex (p < 0.05) contributed significantly to the model for LIBRA. Age and presence of hallucinations (p < 0.05) contributed significantly to the model for MoPaRDS. Male sex, older age, excessive daytime sleepiness, and moderate–severe motor symptoms (all p < 0.05) contributed significantly to the model for pPREDICT.ConclusionAlthough MoPaRDS is a PD-specific tool for predicting cognitive decline relying on only clinical features, it does not focus on potentially modifiable risk factors. LIBRA does focus on potentially modifiable risk factors and is associated with prediction of all-cause dementia in some populations, but pPREDICT potentially demonstrates improved performance in cognitive decline risk calculation in individuals with PD and may identify actionable risk factors. As pPREDICT incorporates multiple potentially modifiable risk factors that can be obtained easily in the clinical setting, it is a first step in developing an easily assessable tool for a personalized approach to reduce dementia risk in people with PD. |
| first_indexed | 2024-03-11T15:58:52Z |
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| issn | 1662-453X |
| language | English |
| last_indexed | 2024-03-11T15:58:52Z |
| publishDate | 2023-10-01 |
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| series | Frontiers in Neuroscience |
| spelling | doaj.art-602fa9c249974944bb44deb5b94daa762023-10-25T08:35:41ZengFrontiers Media S.A.Frontiers in Neuroscience1662-453X2023-10-011710.3389/fnins.2023.12788171278817Original research: initial development of a pragmatic tool to estimate cognitive decline risk focusing on potentially modifiable factors in Parkinson’s diseaseTara C. Carlisle0Tara C. Carlisle1Tara C. Carlisle2Luis D. Medina3Samantha K. Holden4Samantha K. Holden5Samantha K. Holden6Samantha K. Holden7Department of Neurology, Behavioral Neurology Section, University of Colorado School of Medicine, Aurora, CO, United StatesUniversity of Colorado Alzheimer’s and Cognition Center, Aurora, CO, United StatesUniversity of Colorado Movement Disorders Center, Aurora, CO, United StatesDepartment of Psychology, University of Houston, Houston, TX, United StatesDepartment of Neurology, Behavioral Neurology Section, University of Colorado School of Medicine, Aurora, CO, United StatesUniversity of Colorado Alzheimer’s and Cognition Center, Aurora, CO, United StatesUniversity of Colorado Movement Disorders Center, Aurora, CO, United StatesDepartment of Neurology, Movement Disorders Section, University of Colorado School of Medicine, Aurora, CO, United StatesIntroductionCognitive decline is common in Parkinson’s disease (PD). Calculating personalized risk of cognitive decline in PD would allow for appropriate counseling, early intervention with available treatments, and inclusion in disease-modifying trials.MethodsData were from the Parkinson’s Progression Markers Initiative de novo cohort. Baseline scores were calculated for Lifestyle for Brain Health (LIBRA) and the Montreal Parkinson Risk of Dementia Scale (MoPaRDS) per prior literature and preliminary Parkinson’s disease Risk Estimator for Decline In Cognition Tool (pPREDICT) by attributing a point for fourteen posited risk factors. Baseline and 5-year follow-up composite cognitive scores (CCSs) were calculated from a neuropsychological battery and used to define cognitive decliners (PD-decline) versus maintainers (PD-maintain).ResultsThe PD-decline group (n = 44) had higher LIBRA (6.76 ± 0.57, p < 0.05), MoPaRDS (2.45 ± 1.41, p < 0.05) and pPREDICT (4.52 ± 1.66, p < 0.05) scores compared to the PD-maintain group (n = 263; LIBRA 4.98 ± 0.20, MoPaRDS 1.68 ± 1.16, pPREDICT 3.38 ± 1.69). Area-under-the-curve (AUC) for LIBRA was 0.64 (95% confidence interval [CI], 0.55–0.73), MoPaRDS was 0.66 (95% CI, 0.58–0.75) and for pPREDICT was 0.68 (95% CI, 0.61–0.76). In linear regression analyses, LIBRA (p < 0.05), MoPaRDS (p < 0.05) and pPREDICT (p < 0.05) predicted change in CCS. Only age stratified by sex (p < 0.05) contributed significantly to the model for LIBRA. Age and presence of hallucinations (p < 0.05) contributed significantly to the model for MoPaRDS. Male sex, older age, excessive daytime sleepiness, and moderate–severe motor symptoms (all p < 0.05) contributed significantly to the model for pPREDICT.ConclusionAlthough MoPaRDS is a PD-specific tool for predicting cognitive decline relying on only clinical features, it does not focus on potentially modifiable risk factors. LIBRA does focus on potentially modifiable risk factors and is associated with prediction of all-cause dementia in some populations, but pPREDICT potentially demonstrates improved performance in cognitive decline risk calculation in individuals with PD and may identify actionable risk factors. As pPREDICT incorporates multiple potentially modifiable risk factors that can be obtained easily in the clinical setting, it is a first step in developing an easily assessable tool for a personalized approach to reduce dementia risk in people with PD.https://www.frontiersin.org/articles/10.3389/fnins.2023.1278817/fullParkinson diseasecognitive dysfunctiondementiamodifiable risk factorspredictor tool |
| spellingShingle | Tara C. Carlisle Tara C. Carlisle Tara C. Carlisle Luis D. Medina Samantha K. Holden Samantha K. Holden Samantha K. Holden Samantha K. Holden Original research: initial development of a pragmatic tool to estimate cognitive decline risk focusing on potentially modifiable factors in Parkinson’s disease Frontiers in Neuroscience Parkinson disease cognitive dysfunction dementia modifiable risk factors predictor tool |
| title | Original research: initial development of a pragmatic tool to estimate cognitive decline risk focusing on potentially modifiable factors in Parkinson’s disease |
| title_full | Original research: initial development of a pragmatic tool to estimate cognitive decline risk focusing on potentially modifiable factors in Parkinson’s disease |
| title_fullStr | Original research: initial development of a pragmatic tool to estimate cognitive decline risk focusing on potentially modifiable factors in Parkinson’s disease |
| title_full_unstemmed | Original research: initial development of a pragmatic tool to estimate cognitive decline risk focusing on potentially modifiable factors in Parkinson’s disease |
| title_short | Original research: initial development of a pragmatic tool to estimate cognitive decline risk focusing on potentially modifiable factors in Parkinson’s disease |
| title_sort | original research initial development of a pragmatic tool to estimate cognitive decline risk focusing on potentially modifiable factors in parkinson s disease |
| topic | Parkinson disease cognitive dysfunction dementia modifiable risk factors predictor tool |
| url | https://www.frontiersin.org/articles/10.3389/fnins.2023.1278817/full |
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