What Level of Parkinson’s Disease Severity Is Associated with Significant Differences in Cognitive Function? (P5.258)
Bibliographic record
Abstract
OBJECTIVE: To investigate the key thresholds in Parkinson’s disease (PD) severity associated with significant differences in cognitive function. BACKGROUND: Cognitive impairment is common in PD. Montreal Cognitive Assessment (MoCA) scores below 26 suggest cognitive impairment. The levels of PD severity generally associated with significant differences of cognitive function are poorly understood. DESIGN/METHODS: The University of Maryland PD Center systematically enrolls PD patients in a prospective longitudinal database. Assessments include the MoCA, UPDRS, and Hoehn & Yahr (HY) staging. Mean MoCA scores were calculated for 10-point increments on the Total UPDRS and for HY stages. ANOVA was performed to determine significant cognitive changes by HY staging and Total UPDRS increments. RESULTS: MoCA ratings were available for 234 patients with Total UPDRS and 155 patients with HY staging. Based on 10-point increments of Total UPDRS, the mean MoCA score showed the earliest statistically significant difference between UPDRS levels 30-39 and 40-49 (MoCA 27.2(1.8) vs. 25.1(4.0); p<.05). When comparing HY stages (<2, 2, 2.5, 3, and >3), a significant difference in MoCA score was observed between HY stages 2.5 and 3 (MoCA 25.6(3.5) vs. 21.8(4.7); p<.05). CONCLUSIONS: The transition of UPDRS ratings from the 30’s to the 40’s and from HY stages 2.5 to 3 is associated with a difference in cognition indicative of differences between intact and mild cognitive impairment (MoCA<26). We have previously reported that similar UPDRS and HY cut-points mark the transition from intact function to disability. The results of this study highlight the importance of these thresholds as markers of change not only in general PD severity and disability, but also in differences in cognitive function. Study Supported by:
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.010 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".