Cognitive profiles at presentation and subsequent cognitive decline and quality of life in Parkinson's disease

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INTRODUCTION: Currently, our ability to predict cognitive decline in Parkinson's disease is limited. METHODS: In 234 dementia-free PD patients, cognitive profiles at baseline were determined using cluster analysis and longitudinal associations with global cognitive z-score, health-related quality of life (HR-QoL), caregiver burden, and risk of reliable cognitive change (RCC) were tested. RESULTS: Participants fell into four cognitive profiles at baseline: normal cognition (n = 108), memory impairment (n = 47), memory and executive function impairment (n = 59), and global cognitive impairment (n = 20). After adjusting for the severity of cognitive impairment, only the memory impairment cluster showed a higher risk of RCC. Baseline cognitive profiles did not predict different rates of cognitive decline, change in HR-QoL, or caregiver burden. DISCUSSION: The memory impairment cluster showed a higher risk of developing a reliable cognitive change; however, baseline cognitive profiles did not consistently predict different rates of cognitive decline, HR-QoL, or caregiver burden. HIGHLIGHTS: Data-driven approach to identify cognitive profiles. Cognitive decline across domains assessed by risk of reliable cognitive change. Cognitive profiles did not predict rate of cognitive decline. Memory impairment profile had a higher risk of reliable cognitive change.

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