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Response to “Parkinson's disease mild cognitive impairment classifications and neurobehavioral symptoms”

Published online by Cambridge University Press:  02 April 2018

Kyla-Louise Horne*
Affiliation:
New Zealand Brain Research Institute, Christchurch, New Zealand Brain Research New Zealand, Christchurch, New Zealand Department of Psychology, University of Canterbury, Christchurch, New Zealand
Daniel J. Myall
Affiliation:
New Zealand Brain Research Institute, Christchurch, New Zealand
Michael R. MacAskill
Affiliation:
New Zealand Brain Research Institute, Christchurch, New Zealand Department of Medicine, University of Otago, Christchurch, New Zealand
Tim J. Anderson
Affiliation:
New Zealand Brain Research Institute, Christchurch, New Zealand Brain Research New Zealand, Christchurch, New Zealand Department of Medicine, University of Otago, Christchurch, New Zealand Department of Neurology, Christchurch Hospital, Christchurch, New Zealand
John C. Dalrymple-Alford
Affiliation:
New Zealand Brain Research Institute, Christchurch, New Zealand Brain Research New Zealand, Christchurch, New Zealand Department of Psychology, University of Canterbury, Christchurch, New Zealand Department of Medicine, University of Otago, Christchurch, New Zealand

Extract

A recent paper, “Parkinson's disease mild cognitive impairment classifications and neurobehavioral symptoms” (McDermott et al., 2017), provides an interesting comparison of the influence of different criteria for Parkinson's disease with mild cognitive impairment (PD-MCI) on progression to dementia (PDD). Unfortunately, McDermott et al. (2017) incorrectly stated that “only 21% of PD-MCI participants (identified with a 1.5 SD cut-off) converted to PDD within four years” (p.6) in our study (Wood et al., 2016). However, the important point made by Wood et al. (2016) was that the proportion of conversions to PDD was 51% when the PD-MCI diagnosis required a minimum of two 1.5 SD impairments within any single cognitive domain, whereas additional PD-MCI patients classified with one impairment at 1.5 SD in each of the two domains (but never two impairments in the same domain) had a non-significant risk of dementia relative to non-MCI patients (11% vs. 6% converted, respectively). Our PDD conversion rate was 38% when combining both 1.5 SD criteria (21/56 PD-MCI patients vs. 4/65 non-MCI patients converted); McDermott et al. (2017) found a 42% conversion rate over three years for similarly described PD-MCI patients (10/24 PD-MCI patients vs. 0/27 non-MCI patients converted). Our study was also part of a multinational study (n = 467) showing that PD-MCI has predictive validity beyond known demographic and PD-specific factors of influence (Hoogland et al., 2017). All three studies found that multiple cognitive domain impairments are common in PD-MCI. Nonetheless, the research community needs to clarify the association between PD-MCI subtypes and, especially, the optimal cognitive markers for dementia risk in PD patients.

Type
Letter to the Editor
Copyright
Copyright © International Psychogeriatric Association 2018 

A recent paper, “Parkinson's disease mild cognitive impairment classifications and neurobehavioral symptoms” (McDermott et al., Reference McDermott, Fisher, Bradford and Camicioli2017), provides an interesting comparison of the influence of different criteria for Parkinson's disease with mild cognitive impairment (PD-MCI) on progression to dementia (PDD). Unfortunately, McDermott et al. (Reference McDermott, Fisher, Bradford and Camicioli2017) incorrectly stated that “only 21% of PD-MCI participants (identified with a 1.5 SD cut-off) converted to PDD within four years” (p.6) in our study (Wood et al., Reference Wood2016). However, the important point made by Wood et al. (Reference Wood2016) was that the proportion of conversions to PDD was 51% when the PD-MCI diagnosis required a minimum of two 1.5 SD impairments within any single cognitive domain, whereas additional PD-MCI patients classified with one impairment at 1.5 SD in each of the two domains (but never two impairments in the same domain) had a non-significant risk of dementia relative to non-MCI patients (11% vs. 6% converted, respectively). Our PDD conversion rate was 38% when combining both 1.5 SD criteria (21/56 PD-MCI patients vs. 4/65 non-MCI patients converted); McDermott et al. (Reference McDermott, Fisher, Bradford and Camicioli2017) found a 42% conversion rate over three years for similarly described PD-MCI patients (10/24 PD-MCI patients vs. 0/27 non-MCI patients converted). Our study was also part of a multinational study (n = 467) showing that PD-MCI has predictive validity beyond known demographic and PD-specific factors of influence (Hoogland et al., Reference Hoogland2017). All three studies found that multiple cognitive domain impairments are common in PD-MCI. Nonetheless, the research community needs to clarify the association between PD-MCI subtypes and, especially, the optimal cognitive markers for dementia risk in PD patients.

References

Hoogland, J. et al. (2017). Mild cognitive impairment as a risk factor for Parkinson's disease dementia. Movement Disorders, 32, 10561065. doi:10.1002/mds.27002.Google Scholar
McDermott, K. L., Fisher, N., Bradford, S. and Camicioli, R. (2017). Parkinson's disease mild cognitive impairment classifications and neurobehavioral symptoms. International Psychogeriatrics, 30, 253260. doi:10.1017/S1041610217002265.Google Scholar
Wood, K.-L. et al. (2016). Different PD-MCI criteria and risk of dementia in Parkinson's disease: 4-year longitudinal study. Npj Parkinson's Disease, 2, 15027. doi:10.1038/npjparkd.2015.27.Google Scholar