Cognitive decline in Parkinson’s disease (PD) is defined as dementia which affects activities of
daily living (ADL) function. Dementia is one of the recognized issues in the treatment of Parkinson’s
disease patients (PDP) as it is becoming a major contributor to morbidity. The objective of
our study was to evaluate the cognitive decline in Parkinson’s disease patients (PDP) and the influence
of cognition on daily living function deterioration in cognitively impaired and cognitively
unimpaired PDP. Cognitively impaired PDP (n = 24), and cognitively unimpaired PDP (n = 16)
were administered MoCA and MMSE performance based tests for cognitive measurements and
Alzheimer’s Disease Cooperative Study Activities of Daily Living Inventory (ADCS-ADL) to determine
everyday functioning. The significances of MoCA and MMSE among cognitively impaired PDP
and cognitively unimpaired PDP in univariant analysis were P < 0.001 and P < 0.05. In partial correlation,
MoCA was strongly related to ADL function as compare to MMSE (r = 0.623, P = 0.001).
Cognitively impaired PDP showed significantly lower score on visuo-construction and attention.
Among all variables of MoCA domains, attention is strongly associated with instrumental activity
daily living (IADL) scores (logistic regression coefficient = 0.672, P = 0.01). These results suggest
that dementia affects daily living performances especially the IADL tasks like attention and execution.
Therefore, the assessment of complex daily activities particularly IADL is probably useful for
the diagnosis of early stage cognitive impairment in PDP. Further MMSE test is less sensitive than
MoCA for detecting significant cognitive decline in PDP and impaired attention is an important
determinant of ADL functions in cognitively impaired PDP.
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