Cognitive Performance in Parkinson’s Disease in the Brain Health Registry

Article type: Research Article

Authors: Cholerton, Brenna^{a; *} | Weiner, Michael W.^{b; c; d; e} | Nosheny, Rachel L.^{b; d} | Poston, Kathleen L.^f | Mackin, R. Scott^{b; d} | Tian, Lu^g | Ashford, J. Wesson^{h; i} | Montine, Thomas J.^a

Affiliations: [a] Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, USA | [b] Department of Veterans Affairs Medical Center, Center for Imaging of Neurodegenerative Diseases, San Francisco, CA, USA | [c] Department of Medicine, University of California San Francisco, San Francisco, CA, USA | [d] Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA | [e] Department of Radiology, University of California San Francisco, San Francisco, CA, USA | [f] Department of Neurology and Neurological Sciences, Stanford University School of Medicine, Palo Alto, CA, USA | [g] Department of Health Research and Policy, Stanford University, Palo Alto, CA, USA | [h] Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA | [i] War Related Illness and Injury Study Center (WRIISC), Veterans Affairs Palo Alto Health Care System, Palo Alto, CA, USA

Correspondence: [*] Correspondence to: Brenna Cholerton, PhD, Stanford University School of Medicine, Department of Pathology, 300 Pasteur Drive L-235, Stanford, CA 94305, USA. Tel.: +1 253 226 4842; E-mail: bchol@stanford.edu.

Abstract: The study of cognition in Parkinson’s disease (PD) traditionally requires exhaustive recruitment strategies. The current study examines data collected by the Brain Health Registry (BHR) to determine whether ongoing efforts to improve the recruitment base for therapeutic trials in Alzheimer’s disease may be similarly effective for PD research, and whether online cognitive measurements can discriminate between participants who do and do not report a PD diagnosis. Participants enrolled in the BHR (age ≥50) with self-reported PD data and online cognitive testing available were included (n = 11,813). Associations between baseline cognitive variables and diagnostic group were analyzed using logistic regression. Linear mixed effects models were used to analyze longitudinal data. A total of 634 participants reported PD diagnosis at baseline with no self-reported cognitive impairment and completed cognitive testing. Measures of visual learning and memory, processing speed, attention, and working memory discriminated between self-reported PD and non-PD participants after correcting for multiple comparisons (p values < 0.006). Scores on all cognitive tests improved over time in PD and controls with the exception of processing speed, which remained stable in participants with PD while improving in those without. We demonstrate that a novel online approach to recruitment and longitudinal follow-up of study participants is effective for those with self-reported PD, and that significant differences exist between those with and without a reported diagnosis of PD on computerized cognitive measures. These results have important implications for recruitment of participants with PD into targeted therapeutic trials or large-scale genetic and cognitive studies.

Keywords: Aging, cognition, neuropsychology, Parkinson’s disease, patient selection, registries

DOI: 10.3233/JAD-181009

Journal: Journal of Alzheimer's Disease, vol. 68, no. 3, pp. 1029-1038, 2019