The 2016 HIGh Heels: Health effects and psychosexual benefITS (HIGH HABITS) study : systematic review of reviews and additional primary studies

Acknowledgements We thank S.M. Barran (Guy’s and St Thomas NHS Foundation Trust) for general comments on the topic and its social context. We thank S. Reynolds for comments as a member of the public on the introduction and discussion, in particular with regard to the social context of the work. Funding This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.Peer reviewedPublisher PD

Cognitive profile and determinants of poor cognition in people without dementia in Parkinson's disease

Background : The Montreal Cognitive Assessment (MoCA) has been recommended as a cognitive screening tool for clinical practice and research in Parkinson's disease (PD), yet no normative data have been published for MoCA in PD without dementia. Methods : We undertook a pooled secondary analysis of data from two studies (one cross-sectional design and one clinical trial) conducted in the East of England region. All participants were aged 18 years or over, met UK Brain Bank criteria for PD and did not have clinical dementia. Cognitive status was assessed using MoCA at baseline in both studies. The influences of age, gender, disease duration, medication load (LEDD) and mood (HADS) on cognition were examined using regression analysis. Results : Data from 101 people with PD without dementia were available (mean age 71 years, 66% men). Median (IQR) MoCA was 25(22, 27). Age was found as the only predictor of MoCA in this sample. People aged over 71 had poorer MoCA (Beta=0.6 (95%CI 0.44, 0.82)) and an increased odds of MoCA <26 (Beta=0.29 (95%CI 0.12, 0.70)) as well as poorer scores on several MoCA sub-domains. Conclusion : We present the normative data for MoCA in people with PD without clinical dementia. Age appeared to be the only associated factor for lower level of cognition, suggestive of Mild cognitive impairment in PD (PD-MCI) in PD without clinical diagnosis of dementia