Table 1 Updated clinical criteria for the diagnosis of PD-MCI and PDD
From: Cognitive disorders in advanced Parkinson’s disease: challenges in the diagnosis of delirium
PD-MCI (according to [7]) | Probable PDD (according to [8]) | |
|---|---|---|
Inclusion/exclusion criteria | Diagnosis of idiopathic PD Gradual cognitive decline (reported by patient, caregiver or clinician) Deficits at neuropsychological testing Deficits not significantly interfering with functional independence Absence of dementia or other explanations for cognitive deficits | Diagnosis of idiopathic PD Dementia syndrome with insidious onset and slow progression (cognitive impairment in more than one cognitive domain; decline from premorbid level, severe enough to impair daily life) Typical profile of neuropsychological deficits (impairment in at least two of the four core cognitive domains: attention, executive functions, visuo-spatial functions, memory) Absence of other explanations for cognitive deficits (acute confusion due to systemic diseases/abnormalities or drug intoxication; major depression; probable vascular dementia) |
Specific guidelines for operationalization | According to [7] | According to [9] |
Certainty level I | Abbreviated assessment (e.g. global cognitive scale, limited battery of neuropsychological tests) | Abbreviated assessment: MMSE, Pill Questionnaire, Month reversed (or Seven backwards), lexical fluency (or Clock drawing), MMSE pentagons, 3-Word recall |
To be fulfilled | Abnormal global score or one abnormal* test in two domains | MMSE < 26, impairment in more than one of the tasks: month reversed (or seven backwards), lexical fluency (or clock drawing), MMSE pentagons, 3-word recall |
Certainty level II | Comprehensive neuropsychological testing of each of the following five domains (minimum two tests for each domain): Attention/working memory Executive functions Language Memory Visuospatial functions | Comprehensive neuropsychological testing: global cognitive efficiency, executive functions, memory, language, visuospatial skills, neuropsychiatric features (apathy, depression, visual hallucinations, psychosis) |
To be fulfilled | ≥ two abnormal* tests in one domain or one abnormal* test in two domains, whole number of tests not explicitly specified | Use of age- and education-based normal values; impairment in at least two of the four core cognitive domains: attention, executive functions, visuo-spatial functions, memory; behavioral features not mandatory |