Changes in subjective and objective cognitive decline in non‐depressed, non‐demented patients with Parkinson's disease: A 1 to 2 years’ follow‐up
Bibliographic record
Abstract
Abstract Background Subjective and objective cognitive impairments were prevalent in patients with Parkinson’s disease (PD), but there is no data on longitudinal cognitive change in these patients in Thailand. We aimed to evaluate the cognition, perception of cognitive decline, and the diagnosis of cognitive impairment in Thai patients with PD after 1‐2 follow‐up. Method Non‐demented, non‐depressed PD patients were included from the Movement Disorder Clinic at Siriraj Hospital. Patients with severe motor symptoms that interfered with cognitive tests were excluded. We used the Montreal Cognitive Assessment‐Thai version (MoCA) to assess cognition. Perception of cognitive decline was assessed by using the Cognitive Change Index (CCI) rated by patients (CCI‐S) and their informants (CCI‐I). All parameters were assessed at baseline and re‐evaluated at 1‐2 years. Association of MoCA, CCI‐S, CCI‐I, the discrepancy of CCI (CCI‐D; CCI‐S minus CCI‐I), apathy score, and patients’ clinical characteristics were analyzed. Result Sixty‐two participants were followed for 18.59±4.55 months. The mean age at baseline was 63.38±9.63 years, and the mean duration of PD diagnosis was 5.63±3.49 years. The MoCA score slightly declined from 20.6±5.1 at baseline to 20.1±4.9 (mean changes ‐0.53±3.2, p=0.195). 47.1% of patients with normal cognition at baseline converted to PD‐MCI. Most (77.8%) PD‐MCI patients remained in the MCI stage, 11.1% turned to dementia, and 11.1% reverted to normal. The CCI‐I and apathy scores increased significantly after 1‐2 years (p=0.003 and <0.001, respectively), but not the CCI‐S. After controlling with age, gender, and education, the 14‐item Starkstein Apathy Scale score at follow‐up was significantly associated with the CCI‐I and the MoCA scores (r = 0.37 and ‐0.34, respectively, both p<0.01). Moreover, change in MoCA scores was significantly associated with the score of CCI‐D at follow‐up (r=‐0.29, p=0.03). Participants with orthostatic hypotension had a lower MoCA score at follow‐up (p=0.04). Conclusion Apathy, informant perception of cognitive decline, but not the cognition, were changed significantly in non‐demented PD patients after 1‐2 years follow‐up. Apathy, the discrepancy of perception of cognitive decline between participant and informant, and orthostatic hypotension may be related to the lower cognition at follow‐up. Further studies with a larger sample size and more extensive neuropsychological evaluation are required.
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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 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".