Cognitive Testing in Late-Stage Parkinson’s Disease: A Critical Appraisal of Available Instruments

Applied Neuropsychology: Adult

Severiano e Sousa, C., Alarcão, J., et al. (2024).

Applied Neuropsychology: Adult, 31(2), 191-202.

<div>This systematic review explores cognitive screening and assessment tools that may be used to in individuals with late stage Parkinson's disease.&nbsp;</div>

Fundação para a Ciência e a Tecnologia (Portugal)

From database inception to May 2019

<div>Published, original studies of any design</div>

60

<div>The authors of this review recommended the following screening and assessment tools for individuals with late-stage Parkinson's disease. They states that these tools "had the best global characteristics and, cumulatively, minimized motor demands and were quick and easy to use" (p. 196):&nbsp;</div> <div> <ul> <li>The <strong>Montreal Cognitive Assessment (MoCA)</strong> may be used for global cognition and visuospatial function. Reported psychometrics for the MoCA included: sensitivity (Sen) = 94%, specificity (Spec) = 45%, positive predictive value (PPV) = 59%, negative predictive value = 91%, and area under the curve (AUC) = 0.7.&nbsp;</li> <li>The <strong>Digit Span Backwards subtest of the Wechsler Adult Intelligence Scales (WAIS) </strong>may be used for executive function and attention. Reported psychometrics for this subtest included: Sen = 85%, Spec = 44%, PPV = 39%, NPV = 87%, AUC = 0.7.&nbsp;</li> <li>The <strong>Trail Making Test (TMT)</strong> may be used for executive function and attention by calculating the difference between parts B and A to remove the speed element. Reported psychometrics for this calculation included: Sen = 68%, Spec = 91%, PPV = 76%, NPV = 87%, AUC = 0.8.&nbsp;</li> <li>A <strong>semantic fluency task </strong>may be used&nbsp;for attention, executive function, and language. Reported psychometrics for this task included: Sen = 74%, Spec = 53%, PPV = 40%, NPV = 82%, AUC = 0.7.&nbsp;</li> <li>The&nbsp;<strong>Boston Naming Test (BNT)</strong> <strong>Short Version</strong> may be used&nbsp;for language. Reported psychometrics for the BNT Short Version included: Sen = 67%, Spec = 89%, PPV = 88%, NPV = 70%, AUC = 0.8.&nbsp;</li> <li>The <strong>Judgement of Line Orientation (JoLO)</strong> may be used for visuospatial function. Reported psychometrics for the JoLO included: Sen = 59%, Spec = 78%, PPV = 73%, NPV = 66%, AUC = 0.7.&nbsp;</li> <li>The <strong>Clock Drawing Test (CDT)</strong> may be used for attention, executive function, and visuospatial function. Reported psychometrics for the CDT included: Sen = 59%, Spec = 78%, PPV = 73%, NPV = 66%, AUC = 0.7.&nbsp;</li> <li>The <strong>Brief Visuospatial Memory Test-Revised (BVMT-R)</strong> may be used for visual episodic memory. No psychometrics were reported for the BVMT.&nbsp;</li> <li>The <strong>Rey Auditory Verbal Learning Test (RAVLT)</strong> may be used for memory. <ul> <li>Reported psychometrics for the&nbsp;<strong>RAVLT Immediate Recall subtest</strong> included: Sen = 68%, Spec = 78%, PPV = 57%, NPV = 85%, AUC =0.7.</li> <li>Reported psychometrics for the&nbsp;<strong>RAVLT Delayed Recall subtest</strong>&nbsp;included Sen = 74%, Spec = 64%, PPV = 46%, NPV = 85%, AUC = 0.7.&nbsp;</li> </ul> </li> </ul> </div> <div>It is important to note that these psychometric properties are for the tools' general use, and not specific to individuals with late-stage Parkinson's disease. To date, there were no tools validated for use in this population.&nbsp;</div>