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Abstract Details

Developing a Preliminary Parkinson’s Disease Risk Estimator for Decline In Cognition Tool (pPREDICT) as a Practical and Pragmatic Tool to Estimate Risk of Cognitive Decline
Aging, Dementia, and Behavioral Neurology
P1 - Poster Session 1 (9:00 AM-5:00 PM)
072
Develop a preliminary predictive tool for Parkinson’s disease (PD) associated cognitive decline based on clinical history and assessment.
Cognitive decline is exceedingly common in Parkinson’s disease. There is currently no existing predictor tool focused on modifiable risk factors for cognitive decline in PD.

Data were obtained from the Parkinson’s Progression Markers Initiative (PPMI) database. A preliminary model was developed using fourteen predicted risk factors (i.e., older age, male sex, non-white race and/or Hispanic ethnicity, low education, longer symptom duration, low cognitive screening score, low physical activity, depression, anxiety, excessive daytime sleepiness, RBD, severe motor symptoms, vascular risk factors, and obesity). Each risk factor represented a point towards the pPREDICT score.

 

Baseline and 5-year follow-up composite cognitive scores (CCSs) were calculated as a mean of the cognitive measure z-scores. Cognitive decliners (PD-decline) were defined as ≥0.5 SD CCS decline from baseline to follow-up versus maintainer (PD-maintain). Logistic regression analysis with the binary outcome of PD-maintain versus PD-decline was run with the pPREDICT score as a continuous variable.

The PD-decline group (4.32±1.74) has a higher PREDICT score (p = 0.001) compared to the PD-maintain group (3.34±1.68) with OR 1.40 (95% CI 1.18., 1.66). The AUC is 0.66 with 71.0% sensitivity and 55.3% specificity using ≥4 cutoff score. Logistic regression of risk factors identified low education (p = 0.002) and excessive daytime sleepiness (p = 0.010) as contributing to the model.
The pPREDICT identified only excessive daytime sleepiness and lower education as significant risk factors predicting cognitive decline in PD. Given the variable cognitive trajectories in PD, using CCS may mask decline isolated to a single cognitive domain. An approach to develop a full PREDICT model using latent class mixed modeling with raw neuropsychological test scores as outcome measures while focusing on modifiable risk factors is currently underway.
Authors/Disclosures
Tara Carlisle, MD, PhD (University of Colorado AMC Neurology Dept)
PRESENTER 		The institution of Dr. Carlisle has received research support from University of Colorado Denver | Anschutz Medical Campus - NIH Gap Funding. The institution of Dr. Carlisle has received research support from Interdepartmental Alzheimer's Disease Clinical Care and Research Award | Maria Teresa Jones Alzheimer's Disease Fund. The institution of Dr. Carlisle has received research support from NIH/NIA R01AG071151 (PI: Potter). The institution of Dr. Carlisle has received research support from Anschutz Acceleration Initiative Research Grant (PI: Matlock/Glasgow). Dr. Carlisle has received personal compensation in the range of $500-$4,999 for serving as a Speaker with ADRD Research 好色先生 and Appreciation Event. Dr. Carlisle has a non-compensated relationship as a Invited Speaker with Parkinson Association of the Rockies that is relevant to AAN interests or activities. Dr. Carlisle has a non-compensated relationship as a Invited Speaker with Women in Neurology Group that is relevant to AAN interests or activities. Dr. Carlisle has a non-compensated relationship as a Invited Speaker with 好色先生 that is relevant to AAN interests or activities. Dr. Carlisle has a non-compensated relationship as a Invited Speaker with American Neuropsychiatry Association that is relevant to AAN interests or activities. Dr. Carlisle has a non-compensated relationship as a Ad hoc Reviewer with The Journal of Neuropsychiatry and Clinical Neurosciences that is relevant to AAN interests or activities. Dr. Carlisle has a non-compensated relationship as a Ad hoc Reviewer with Frontiers in Neuroscience, Neurodegeneration Section that is relevant to AAN interests or activities. Dr. Carlisle has a non-compensated relationship as a Speaker with Alzheimer's Association that is relevant to AAN interests or activities. Dr. Carlisle has a non-compensated relationship as a Expert for Media Reports with UCHealth Today that is relevant to AAN interests or activities. Dr. Carlisle has a non-compensated relationship as a Expert for Media Reports with Rocky Mountain PBS that is relevant to AAN interests or activities. Dr. Carlisle has a non-compensated relationship as a Expert for Media Reports with Neurology Today that is relevant to AAN interests or activities.
No disclosure on file
No disclosure on file
No disclosure on file
Samantha K. Holden, MD, MS, FAAN (University of Colorado School of Medicine) The institution of Dr. Holden has received personal compensation in the range of $500-$4,999 for serving on a Scientific Advisory or Data Safety Monitoring board for Cognition Therapeutics.