Association between Subjective Cognitive Complaints and Incident Functional Impairment in Parkinson's Disease.
Association between Subjective Cognitive Complaints and Incident Functional Impairment in Parkinson's Disease.
Where did the research take place?
The study site has not been established. Author addresses may differ from where the research occurred.
Philadelphia, US · Author affiliation
Departments of Psychiatry and Neurology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA.Location evidence
Toronto, CA · Author affiliation
Edmond J. Safra Program in Parkinson's Disease, University Health Network, University of Toronto, Toronto, Ontario, Canada.Location evidence
US · Author affiliation · country only
Department of Neurology, University of Colorado Anschutz Medical Campus, Aurora, Colorado, USA.Location evidence
Pittsburgh, US · Author affiliation
Department of Neurology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.Location evidence
New York City, US · Author affiliation
Department of Biostatistics and Computational Biology, University of Rochester, Rochester, New York, USA.Location evidence
San Francisco, US · Author affiliation
Grey Matter Technologies, a Wholly Owned Subsidiary of modality.ai, San Francisco, California, USA.Location evidence
Durham, US · Author affiliation
Department of Neurology, Duke University, Durham, North Carolina, USA.Location evidence
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Original abstract
BackgroundEarly identification of subjective cognitive complaints (SCC) in Parkinson's disease (PD) may improve patient care if it predicts cognition-related functional impairment (CFI).ObjectivesThe aim was to determine the cross-sectional and longitudinal association between SCC and CFI in PD.MethodsData were obtained from Fox Insight, an online longitudinal study that collects PD patient-reported outcomes. Participants completed a PD Patient Report of Problems that asked participants for their five most bothersome disease problems. SCCs were placed into eight categories through human-in-the-loop curation and classification. CFI had a Penn Parkinson's Daily Activities Questionnaire (PDAQ-15) score ≤49. Cox proportional hazards models and Kaplan-Meier survival analyses determined if baseline SCC was associated with incident CFI.ResultsThe PD-PROP cohort (N = 21,160) was 55.8% male, mean age was 65.9 years, and PD duration was 4.8 years. At baseline, 31.9% (N = 6750) of participants reported one or more SCCs among their five most bothersome problems, including memory (13.2%), language/word finding (12.5%), and concentration/attention (9.6%). CFI occurred in 34.7% (N = 7332) of participants. At baseline, SCC was associated with CFI (P-value <0.001). SCC at baseline was associated with incident CFI (hazard ratio [HR] = 1.58 [95% confidence interval: 1.45, 1.72], P-value <0.001), as did cognitive impairment not otherwise specified (HR = 2.31), executive abilities (HR = 1.97), memory (HR = 1.85), and cognitive slowing (HR = 1.77) (P-values <0.001). Kaplan-Meier curves showed that by year 3 an estimated 45% of participants with any SCC at baseline developed new-onset CFI.ConclusionsSelf-reported bothersome cognitive complaints are associated with new-onset CFI in PD. Remote electronic assessment can facilitate widespread use of patient self-report at population scale. © 2024 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.