Prevalence and Subtypes of Mild Cognitive Impairment in Parkinson's Disease.

The current study examined the prevalence and subtypes of Mild Cognitive Impairment (MCI) in an Australian sample of people with Parkinson's Disease (PD). Seventy participants with PD completed neuropsychological assessments of their cognitive performance, using MDS Task Force Level II diagnostic criteria for PD-MCI. A cut-off score of less than one standard deviation (SD) below normative data determined impaired performance on a neuropsychological test. Of 70 participants, 45 (64%) met Level II diagnostic criteria for PD-MCI. Among those with PD-MCI, 42 (93%) were identified as having multiple domain impairment (28 as amnestic multiple domain and 14 as nonamnestic multiple domain). Single domain impairment was less frequent (2 amnestic/1 nonamnestic). Significant differences were found between the PD-MCI and Normal Cognition groups, across all cognitive domains. Multiple domain cognitive impairment was more frequent than single domain impairment in an Australian sample of people with PD. However, PD-MCI is heterogeneous and current prevalence and subtyping statistics may be an artifact of variable application methods of the criteria (e.g., cut off scores and number of tests). Future longitudinal studies refining the criteria will assist with subtyping the progression of PD-MCI, while identifying individuals who may benefit from pharmacological and nonpharmacological interventions

Neuropsychological Assessment in Geriatric Forensic Psychiatry

While memory complaints are ubiquitous among elders, and memory impairment is one of the most significant aspects of cognitive dysfunction in elderly persons, deficits in other cognitive domains can also negatively impact the ability of elderly individuals to function independently and can have marked consequences in the forensic arena. Neuropsychological assessment is a critical element in identifying cognitive changes that can have a negative impact on legal capacity. Information about cognitive vulnerabilities, combined with data concerning day-to-day functioning, provides critical information to identify what specific areas of capacity may be impaired, and wherever possible, identify the least restrictive accommodations to preserve the individual’s dignity and autonomy. This chapter outlines the components and procedures associated with forensic neuropsychological assessments to help the practitioner understand the potential utility of these types of assessments and how to critically evaluate and interpret the neuropsychological findings regarding the geriatric client within the forensic setting.</p

Utility of the Cognitive Difficulties Scale and Association With Objective Test Performance

Subjective memory complaints (SMCs) are commonly noted in memory disorder clinic patients. The present study sought to examine the presence of SMCs on the Cognitive Difficulties Scale (CDS) in older adults and to examine the relationship between CDS scores and current cognitive ability. Participants were 50 adults diagnosed with possible/probable Alzheimer’s disease (AD), 100 with amnestic mild cognitive impairment (MCI) and 84 cognitively healthy controls (HCs). Participants completed a neuropsychological evaluation and the self- and informant-reported CDS. Results indicated that greater self-reported SMCs were noted in the group with MCI ; however, self-reported CDS scores were associated with cognition in HCs only. Informant-reported CDS scores were predictive of cognitive ability in the diagnosis of MCI but not AD, indicating the importance of obtaining caregiver report in the evaluation of memory disorders. As AD is a neurodegenerative disorder, SMCs lose value in determining degree of cognitive impairment as disease stage increases. </jats:p