We conducted an observational study to investigate clinical predictors of cognitive decline in patients with mild cognitive impairment (MCI), with a focus on patients with Parkinson’s disease (PD) and Alzheimer’s disease (AD). The study was performed with detailed neuropsychological testing, a portable device for gait analysis, and a comprehensive geriatric assessment for patients with MCI. Cognitive decline was defined as subjective cognitive impairment with an objective decline in the Mini-Mental State Examination (MMSE) ≥2 points at the one-year follow-up. Participants (n = 74) had a median age of 70 (interquartile range 60–79) years, and 45.9% of them were women. At the end of the study, 17.6% of the patients with MCI had a cognitive decline. Although no differences were observed between groups at the baseline cognitive study, patients with PD-MCI demonstrated more cognitive decline than patients with AD-MCI (28.6% vs. 7.7%  = 0.03). Patients with PD-MCI had more physical disabilities, including scores of instrumental activities of daily living (IADL), Tinetti balance, and gait scores, and some Timed Up and Go components. Initial Clinical Dementia Rating—Sum of Boxes score was a better predictor of future cognitive decline than MMSE in PD-MCI. For predicting the occurrence of cognitive decline in PD-MCI, the prediction accuracy increased from the reduced model (AUC = 0.822, ) to the full model (a total of five independent variables, AUC = 0.974, ). Given the potentially modifiable predictor, our findings also highlight the importance of identifying sleep quality and the ability to perform IADL.

中文翻译：

---

预测患有轻度认知障碍的帕金森氏病的认知能力下降：一项为期一年的观察性研究

我们进行了一项观察性研究，以调查轻度认知障碍（MCI）患者认知能力下降的临床预测因素，重点是帕金森氏病（PD）和阿尔茨海默氏病（AD）患者。这项研究是通过详细的神经心理学测试，用于步态分析的便携式设备以及针对MCI患者的全面的老年医学评估来进行的。认知功能减退被定义为主观认知障碍，在一年的随访中客观状态的最低精神状态检查（MMSE）≥2分。参加人数 = 74岁）的平均年龄为70岁（四分位间距为60-79岁），其中45.9％是女性。在研究结束时，有17.6％的MCI患者出现认知能力下降。尽管在基线认知研究中两组之间没有观察到差异，但是PD-MCI患者比AD-MCI患者表现出更多的认知下降（28.6％比7.7％ = 0.03）。PD-MCI患者有更多的身体残疾，包括日常生活中的器械活动（IADL）得分，Tinetti平衡和步态得分以及一些Timed Up and Go组件。初始临床痴呆评分-Box-Sum评分比PD-MCI中的MMSE更能预测未来的认知能力下降。为了预测PD-MCI中认知功能下降的发生，从简化模型中提高了预测准确性（AUC = 0.822，）到完整模型（总共五个自变量，AUC = 0.974，）。考虑到潜在的可修改的预测因素，我们的发现还强调了识别睡眠质量和执行IADL能力的重要性。