MDS 2025 | The prevalence of cognitive impairment in Parkinson’s disease and the need to standardize assessment

In terms of the prevalence of cognitive impairment in Parkinson’s, you know, we think of Parkinson’s as a movement disorder, which it is, it’s defined by its motor features, but the cognitive aspect or features of Parkinson’s disease are kind of intrinsic to the disease. So when we look at prevalence, for example, prevalence of Parkinson’s disease dementia or point prevalence is around 30%. But when we actually look at the cumulative risk over time, I always quote this one study from Australia, which found that 20 years after the point of their initial Parkinson’s diagnosis, 80% of their sample had developed dementia. And I think to me, this just shows how core of a feature, the cognitive aspect of Parkinson’s disease is essentially, if you live long enough, you’re probably going to have some form of cognitive decline. And this is why it’s really important to kind of try and identify the cognitive features of Parkinson’s disease, you know, as early as possible. So we can identify these people and get them the support and the care that they need before they lose capacity. So this is where the idea of MCI kind of was brought in. So MCI is mild cognitive impairment, and it’s the transitional stage, just before dementia where cognitive deficits are observable, but there’s no actual impairment in terms of activities of daily living. So when we look at the prevalence of MCI at the time of Parkinson’s diagnosis, that’s when we see anywhere between 15 to 40% of research samples have been diagnosed with MCI at the time of diagnosis, Parkinson’s diagnosis. And yeah, so I think what these kind of demonstrate is that the cognitive deficits are present even from early stages of the disease. And as the disease progresses, there’s an increased chance of developing some form of cognitive decline. In terms of why we need standardized guidelines to diagnose and assess and manage these cognitive disorders in Parkinson’s is because the most recent guidelines or criteria for dementia and MCI in Parkinson’s was produced you know 10-15 years ago from that Movement Disorder Society. And in that time there’s been a lot of changes in terms of, new evidence has come out in terms of how we should diagnose assess and manage cognitive features of Parkinson’s and yeah not only that but in terms of what’s happening in clinic at the moment, people are using such different methodologies in terms of particularly neuropsychological assessment to identify these disorders. And so by standardizing the way that we diagnose and assess cognitive disorders and Parkinson’s, we really hope to optimize the type of care that we can provide.

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