Determining cognitive impairment not noted by the patient or their caregiver in Parkinson's or Lewy Body Disease in a Comprehensive Cognition Clinic (CCC Clinic)

Parkinson’s disease (PD) and Dementia with Lewy Bodies (DLB) are neurodegenerative disorders that frequently involve non-motor symptoms such as psychiatric signs and cognitive impairment. These impact quality of life and rarely recognized by physicians, due to time constraints or lack of verified measures of cognitive impairment. Cognitive testing in a comprehensive clinic can better recognize these symptoms. Researchers have shown that early cognitive intervention can help delay cognitive decline in patients with PD. For these reasons, one of the first in country CCC clinic was formed at MedStar Georgetown University Hospital, where all PD and LBD patients have regular cognition-focused visits to address cognitive concerns. 

This study consists of a retrospective chart review from 8 months of CCC clinic visits with patients diagnosed with Parkinsonism, PD, or DLB. The data collected includes demographic information, diagnosis, cognitive and psychiatric testing results. The cognitive test used is the Montreal Cognitive Assessment (MoCA), a widely accepted measure for cognitive decline and dementia.

Many patients or caregivers can identify moderate to severe cognitive impairment. Regular screening can help detect patients who have MCI and will allow physicians time to start treatment before disease progression. Comprehensive cognitive care model is an unmet need in identifying cognitive concerns for our patients. Further study is needed to determine if this care model can promote better outcomes for patients in the long term.