OBJECTIVE: To compare the scores of patients with idiopathic Parkinson's Disease using the Montreal Cognitive Assessment and Mini-Mental State Examination in a tertiary hospital
BACKGROUND: Parkinson's Disease (PD) is a neurodegenerative disorder diagnosed clinically based on the signs of resting tremor bradykinesia, rigidity and loss of postural reflexes. According to Bassett et al, 20% to 40% of PD patients ultimately become demented with an incidence of 10% per year. Cognitive decline is an impotant predictor of dementia in PD. Almost all patients with PD suffer from selective cognitive impairments including difficulties with attention, concentration, planning, sequencing, concept formation, problem solving, set-shifting and memory which are thought ro reflect dysfunction of cortical circuits subserving frontal brain regions. Identification of cognitive impairment in PD is crucial. It predicts future cognitive decline and may eventually be a target for pharmacologic intervention to prevent or delay the development of dementia.
METHODS: A descriptive study. A convenience sampling of 95 patients with idiopathic Patkinson's disease were screened for cognitive impairment.
RESULTS: Mean MMSE and MoCA scores were 26.1 (SD 2.9) and 19.8 (SD 4.28). Based on the published cutoff scores for cognitive impairment for Parkinson's Disease, 72% of the participants scored 26/30 and below on MoCA whereas only 42% scored 26/30 and below on the MMSE. Impairments were seen in numerous cognitive domains including executive function, language, recent semantic memory, visuo-spatial processing and constructional praxis. Predictors of cognitive impairment on the MoCA include low level of education and older age.
CONCLUSIONS: MoCA was able to detect more cognitive impairments in patients with Parkinson's disease than MMSE. Therefore, MoCA is a better screening tool to detect cognitive impairments in PD patients.